Provider Demographics
NPI:1003435801
Name:DUFF, DAVID BYRON
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BYRON
Last Name:DUFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9295 MEDICAL PLAZA DR # AB
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9137
Mailing Address - Country:US
Mailing Address - Phone:843-797-3960
Mailing Address - Fax:843-553-4216
Practice Address - Street 1:9295 MEDICAL PLAZA DR # AB
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9137
Practice Address - Country:US
Practice Address - Phone:843-797-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-11
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC86319207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology