Provider Demographics
NPI:1376322875
Name:MCDUFFIE, ANTHONY LEONRAD I
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LEONRAD
Last Name:MCDUFFIE
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 T ST NW # B3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1842
Mailing Address - Country:US
Mailing Address - Phone:202-650-7044
Mailing Address - Fax:
Practice Address - Street 1:2001 15TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-5828
Practice Address - Country:US
Practice Address - Phone:202-407-5331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide