Provider Demographics
NPI:1609808567
Name:ENGEL, JENNIFER DUCK (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DUCK
Last Name:ENGEL
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 1:311 MONTROSE DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-6787
Mailing Address - Country:US
Mailing Address - Phone:732-239-0357
Mailing Address - Fax:
Practice Address - Street 1:5244 N SHARON AMITY RD # B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-0053
Practice Address - Country:US
Practice Address - Phone:704-536-0073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-01241208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics