Provider Demographics
NPI:1366480402
Name:DUNCAN, TITUS D (MD)
Entity Type:Individual
Prefix:DR
First Name:TITUS
Middle Name:D
Last Name:DUNCAN
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 1:285 BOULEVARD NE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-4205
Mailing Address - Country:US
Mailing Address - Phone:678-553-3177
Mailing Address - Fax:678-539-3080
Practice Address - Street 1:315 BOULEVARD NE
Practice Address - Street 2:SUITE 224
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1200
Practice Address - Country:US
Practice Address - Phone:678-553-3174
Practice Address - Fax:678-553-3179
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020692174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD39781Medicare UPIN