Provider Demographics
NPI:1093230922
Name:MCDUFFIE, ANN
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:MCDUFFIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8282 GALE AVE
Mailing Address - Street 2:
Mailing Address - City:IVOR
Mailing Address - State:VA
Mailing Address - Zip Code:23866-2840
Mailing Address - Country:US
Mailing Address - Phone:240-381-0323
Mailing Address - Fax:
Practice Address - Street 1:8282 GALE AVE
Practice Address - Street 2:
Practice Address - City:IVOR
Practice Address - State:VA
Practice Address - Zip Code:23866-2840
Practice Address - Country:US
Practice Address - Phone:240-381-0323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver