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Dr. Sean Michael Dougherty, DPM
Foot & Ankle Surgery Podiatrist in Fairfield, California
NPI 1407089261

Sean Michael Dougherty is a Foot & Ankle Surgery Podiatrist based in Fairfield, CA and is specialized in Foot & Ankle Surgery. Sean Michael Dougherty practices in Fairfield, CA and has the professional credentials of DPM. The NPI Number for Sean Michael Dougherty is 1407089261 and holds a License No. E5009 (California).

The current practice location address for Sean Michael Dougherty is 1620 Pennsylvania Ave Ste A, Fairfield, CA and can be reached out via phone at 707-426-5644 and via fax at 707-426-3156.

Location: 1620 Pennsylvania Ave Ste A, Fairfield, CA, 94533-3509
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407089261
Provider Name
Sean Michael Dougherty
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
1620 Pennsylvania Ave Ste A, Fairfield, CA, 94533-3509
Phone Number
707-426-5644
Fax Number
707-426-3156
Provider Enumeration Date
08/27/2009
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
P01083197 01 CA MEDICARE RAILROAD
institution
Provider Business Practice Location Address Details
Address
1620 Pennsylvania Ave Ste A
City
Fairfield
State
California
Zip
94533-3509
Phone Number
707-426-5644
Fax Number
707-426-3156
person
Provider Business Mailing Address Details
Address
1620 Pennsylvania Ave Ste A
City
Fairfield
State
California
Zip
94533-3509
Phone Number
707-426-5644
Fax Number
707-426-3156
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
E5009 (California)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
213EP1101X
License No.
E5009 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Sports Medicine
Taxonomy
213ES0000X
License No.
E5009 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
E5009 (California)
Definition
Definition to come...
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