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General NPI Number Information
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NPI Number | 1043360126
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Entity Type | Individual
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Provider Name | ELIZABETH LEE DAUGHERTY MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 1830 E MONUMENT ST 5TH FLOOR
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City | BALTIMORE
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State | MD
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Zip | 21205-2100
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Country | US
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Telephone | 410-955-3467
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Fax | 410-955-0036
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Provider Business Mailing Address
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Address Line | 5712 ROLAND AVE 1C
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City | BALTIMORE
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State | MD
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Zip | 21210-1351
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Country | US
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Telephone | 410-433-7443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | D64127
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License Number State | MD
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