Provider Demographics
NPI:1972688737
Name:FITCH, DUANE DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:DOUGLAS
Last Name:FITCH
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 3526
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27895-3526
Mailing Address - Country:US
Mailing Address - Phone:252-237-4100
Mailing Address - Fax:252-237-8449
Practice Address - Street 1:2402 CAMDEN ST SW
Practice Address - Street 2:SUITE 300
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8608
Practice Address - Country:US
Practice Address - Phone:252-237-4100
Practice Address - Fax:252-237-8449
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25997207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0202FOtherBLUE CROSS & BLUE SHIELD
NC890202FMedicaid
NC0202FOtherBLUE CROSS & BLUE SHIELD
C83793Medicare UPIN