Provider Demographics
NPI:1639128465
Name:SHUBERT, DUANE DOYLE (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:DOYLE
Last Name:SHUBERT
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:PO BOX 714
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-0714
Mailing Address - Country:US
Mailing Address - Phone:302-227-7399
Mailing Address - Fax:
Practice Address - Street 1:153 BEAVER DAM REACH
Practice Address - Street 2:THE WOODS AT SEASIDE
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-6102
Practice Address - Country:US
Practice Address - Phone:302-227-7399
Practice Address - Fax:302-227-7398
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00058152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE00001021801Medicaid
DEG01413Medicare UPIN
DEG01413D02Medicare ID - Type Unspecified