Provider Demographics
NPI:1164705273
Name:DUNCAN, DOUGLAS EARL (RPH)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:EARL
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11430 N TRYON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-0405
Mailing Address - Country:US
Mailing Address - Phone:704-717-3276
Mailing Address - Fax:
Practice Address - Street 1:11430 N TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-0405
Practice Address - Country:US
Practice Address - Phone:704-717-3276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist