Provider Demographics
NPI:1700827888
Name:DUFFY, DANIEL A (DPM)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:DUFFY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 FOREST RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2913
Mailing Address - Country:US
Mailing Address - Phone:410-308-1654
Mailing Address - Fax:410-308-1657
Practice Address - Street 1:2114 FOREST RIDGE RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-2913
Practice Address - Country:US
Practice Address - Phone:410-308-1654
Practice Address - Fax:410-308-1657
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1014213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD218388900Medicaid
MDU02920Medicare UPIN
MD218388900Medicaid
MD292PMedicare PIN
MD4069430001Medicare NSC
MD490962Medicare ID - Type Unspecified