Provider Demographics
NPI:1275190290
Name:EGGERMAN, DUANE (LMSW)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:
Last Name:EGGERMAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5735 ROWANBERRY DR APT 205
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5222
Mailing Address - Country:US
Mailing Address - Phone:443-401-7667
Mailing Address - Fax:
Practice Address - Street 1:34 DEFENSE ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3577
Practice Address - Country:US
Practice Address - Phone:443-214-5097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD232711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical