Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 2305001075 | VA |
NPI | 1548376544 |
---|---|
Provider Name | Mrs. Rebecca Duncan |
First Address | Lynchburg, VA 24501-1017 |
Second Address | Lynchburg, VA 24501-1017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
087932 | ANTHEM BCBS (01) | VA |
S79409 | (02) | VA |