Provider Demographics
NPI:1437368073
Name:DUVALL, MARY M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:M
Last Name:DUVALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3360 HIGHWAY 411 NORTH
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37329
Mailing Address - Country:US
Mailing Address - Phone:423-887-5131
Mailing Address - Fax:
Practice Address - Street 1:3360 HIGHWAY 411 NORTH
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:TN
Practice Address - Zip Code:37329
Practice Address - Country:US
Practice Address - Phone:423-887-5131
Practice Address - Fax:423-887-5917
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000025023207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine