Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 01041371A | IN |
NPI | 1053393975 |
---|---|
Provider Name | Dr. Marc E. Duerden |
First Address | Indianapolis, IN 46250-2692 |
Second Address | Indianapolis, IN 46250-2692 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 23/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200009000A | (05) | IN |
F55146 | (02) | IN |