Provider Demographics
NPI:1588630750
Name:DOUGHTY, MICHAEL ANTHONY (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:DOUGHTY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3592
Mailing Address - Country:US
Mailing Address - Phone:410-879-1212
Mailing Address - Fax:410-803-1859
Practice Address - Street 1:8100 SANDPIPER CIR STE 104
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5028
Practice Address - Country:US
Practice Address - Phone:410-933-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01316174400000X, 213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No174400000XOther Service ProvidersSpecialist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery