Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D0045495 | MD |
NPI | 1154390714 |
---|---|
Provider Name | Conrad J Duncan |
First Address | Owings Mills, MD 21117-5421 |
Second Address | Baltimore, MD 21229-5072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 03/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005525500 | (05) | MD |
F69992 | (02) |