Provider Demographics
NPI:1134239262
Name:DUNCAN, MIA ADDISON (MD)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:ADDISON
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MIA
Other - Middle Name:ADDISON
Other - Last Name:SWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5150 E DUBLIN GRANVILLE RD STE 220
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8701
Practice Address - Country:US
Practice Address - Phone:614-788-2870
Practice Address - Fax:614-533-0177
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.090191208800000X, 2088F0040X
WAML20007145208800000X
WAMD600824152088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
No208800000XAllopathic & Osteopathic PhysiciansUrology