Provider Demographics
NPI:1346586179
Name:DURE, MARJORIE (MD)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:DURE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 ERNEST GABOURY
Mailing Address - Street 2:
Mailing Address - City:GATINEAU
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:J8V3W1
Mailing Address - Country:CA
Mailing Address - Phone:819-243-2671
Mailing Address - Fax:819-243-2671
Practice Address - Street 1:182 RUE GALIPEAU
Practice Address - Street 2:
Practice Address - City:THURSO
Practice Address - State:QUEBEC
Practice Address - Zip Code:J8V3B0
Practice Address - Country:CA
Practice Address - Phone:819-243-2671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ1110170207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice