Provider Demographics
NPI:1821053851
Name:DUES, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:DUES
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 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:3118 E 10TH ST STE A
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-5904
Practice Address - Country:US
Practice Address - Phone:812-282-6979
Practice Address - Fax:812-282-6998
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30488207R00000X
IN01045680A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN110138274OtherRRMCR
8118208002OtherCIGNA / NCMA
000023934BOtherHUMANA / NCMA
1193931OtherCHA / NCMA
IN200123480Medicaid
00000050971OtherANTHEM - NCMA
2447472000OtherPAD - NCMA
002270OtherSIHO - NCMA
50006204OtherPASSPORT - NCMA
IN200123480Medicaid
002270OtherSIHO - NCMA
000023934BOtherHUMANA / NCMA