Provider Demographics
NPI:1780666727
Name:DUCEY, KEVIN F (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:F
Last Name:DUCEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2001 CRYSTAL SPRING AVE SW
Mailing Address - Street 2:STE 201
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-2462
Mailing Address - Country:US
Mailing Address - Phone:540-344-5781
Mailing Address - Fax:540-342-9308
Practice Address - Street 1:2001 CRYSTAL SPRING AVE SW
Practice Address - Street 2:STE 201
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-2462
Practice Address - Country:US
Practice Address - Phone:540-344-5781
Practice Address - Fax:540-342-9308
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101033205208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7421826Medicaid
VA7421826Medicaid