Daugherty, Michael Wayne

Daugherty, Michael Wayne is an individual health care provider with primary practice located at 350 W Columbia St Ste 420 , Evansville IN 47710. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Daugherty, Michael Wayne can be contacted via phone (812) 422-3254.

Contact Information

Primary practice address
350 W Columbia St Ste 420 Evansville IN 47710
Phone: (812) 422-3254
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01080455A Indiana

Profile Details

NPI number 1124371067
LBN Legal business name Daugherty, Michael Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2012
Last updated Feb 26th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124371067 NPPES
Indiana MEDICAID 300014772
Indiana MEDICAID 7100547700

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