Provider Demographics
NPI:1245260413
Name:MCKINNEY, DUANE ANTHONY (DPM)
Entity type:Individual
Prefix:
First Name:DUANE
Middle Name:ANTHONY
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7708 HANOVER PKWY
Mailing Address - Street 2:APT 201
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2633
Mailing Address - Country:US
Mailing Address - Phone:301-982-2525
Mailing Address - Fax:301-262-6486
Practice Address - Street 1:7404 EXECUTIVE PL
Practice Address - Street 2:SUITE 501
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2268
Practice Address - Country:US
Practice Address - Phone:301-262-6314
Practice Address - Fax:301-262-6486
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01331213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU85108Medicare UPIN