Provider Demographics
NPI:1558300723
Name:DAUGHERTY, STEVE D (DO)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:D
Last Name:DAUGHERTY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6098 DEBRA RD
Mailing Address - Street 2:6200 BUILDING, SUITE6200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5702
Mailing Address - Country:US
Mailing Address - Phone:423-893-6500
Mailing Address - Fax:423-892-3028
Practice Address - Street 1:6098 DEBRA RD
Practice Address - Street 2:6200 BUILDING, SUITE6200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5702
Practice Address - Country:US
Practice Address - Phone:423-893-6500
Practice Address - Fax:423-892-3028
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2024-01-02
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Provider Licenses
StateLicense IDTaxonomies
TND0708207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BO4905Medicare UPIN
GA00319404DMedicaid
BO4905Medicare UPIN