Provider Demographics
NPI:1922307297
Name:HARRY E. DUNCAN, JR., M.D., PLLC
Entity Type:Organization
Organization Name:HARRY E. DUNCAN, JR., M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:304-400-4508
Mailing Address - Street 1:5 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2696
Mailing Address - Country:US
Mailing Address - Phone:304-400-4508
Mailing Address - Fax:304-400-4517
Practice Address - Street 1:5 COURTNEY DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2696
Practice Address - Country:US
Practice Address - Phone:304-400-4508
Practice Address - Fax:304-400-4517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10533207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVA72062Medicare UPIN