Provider Demographics
NPI:1629160577
Name:DUCK, ROBERT W (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:DUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:812 AMHERST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3344
Mailing Address - Country:US
Mailing Address - Phone:540-722-0220
Mailing Address - Fax:540-722-0191
Practice Address - Street 1:812 AMHERST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3344
Practice Address - Country:US
Practice Address - Phone:540-722-0220
Practice Address - Fax:540-722-0191
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101221410207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00174961OtherMEDICARE RR
VA00W051V01Medicare PIN
H04306Medicare UPIN