Provider Demographics
NPI:1346393360
Name:RODRIGUEZ-WINTER, DUANE A (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:A
Last Name:RODRIGUEZ-WINTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140368
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-0368
Mailing Address - Country:US
Mailing Address - Phone:419-350-0977
Mailing Address - Fax:
Practice Address - Street 1:1125 MORACK DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-4165
Practice Address - Country:US
Practice Address - Phone:419-350-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0491612084P0800X
CAG569822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2058642Medicaid
H091220Medicare PIN
OH2058642Medicaid