Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | D28136 | MD |
NPI | 1255337416 |
---|---|
Provider Name | Dr. Robert Duncan |
First Address | Bel Air, MD 21014-4393 |
Second Address | Bel Air, MD 21014-4393 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 28/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
320391300 | (05) | MD |
D71511 | (02) | MD |