Provider Demographics
NPI:1184924250
Name:DUKE, MARTIN BARRY (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:BARRY
Last Name:DUKE
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 1:5830 HERSHINGER CLOSE
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-6428
Mailing Address - Country:US
Mailing Address - Phone:678-474-9329
Mailing Address - Fax:
Practice Address - Street 1:5830 HERSHINGER CLOSE
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-6428
Practice Address - Country:US
Practice Address - Phone:678-474-9329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-23
Last Update Date:2010-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092269-1207R00000X
NJ25MA01995500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine