Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 38451 | MA |
Y | 208200000X | Surgeon | 38451 | MA |
Y | 208600000X | Surgeon | 38451 | MA |
NPI | 1033162201 |
---|---|
Provider Name | Dr. Bertrand Stevens Duncan |
First Address | Sandwich, MA 02563-2787 |
Second Address | Falmouth, MA 02540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 19/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0149471 | MASS HEALTH PROVIDER (01) | |
H31979 | (02) |