Provider Demographics
NPI:1033495106
Name:DUKE UNIVERSITY
Entity Type:Organization
Organization Name:DUKE UNIVERSITY
Other - Org Name:DUKE STUDENT HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:PURDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-681-2354
Mailing Address - Street 1:DUMC BOX 2899
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710
Mailing Address - Country:US
Mailing Address - Phone:919-681-9355
Mailing Address - Fax:919-681-2874
Practice Address - Street 1:201 TRENT DR
Practice Address - Street 2:SUB-BASEMENT, ORANGE ZONE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-3037
Practice Address - Country:US
Practice Address - Phone:919-681-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health