Provider Demographics
NPI:1457337107
Name:DUNCAN, DOUGLAS DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:DAVID
Last Name:DUNCAN
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 4222
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-0222
Mailing Address - Country:US
Mailing Address - Phone:757-746-5342
Mailing Address - Fax:
Practice Address - Street 1:637 KINGSBOROUGH SQ STE D
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4944
Practice Address - Country:US
Practice Address - Phone:757-746-5342
Practice Address - Fax:833-954-0875
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091324207X00000X
VA0101245575207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1982244083Medicaid
VA1982244083OtherCORNERSTONE PROFESSIONAL ORTHOPAEDICS SPORTS 4 CHRIST
VAJ829OtherCORNERSTONE PROFESSIONAL ORTHOPAEDICS SPORTS 4 CHRIST