Provider Demographics
NPI:1740316181
Name:DUNCAN, NEVILLE WINSTON (MD)
Entity type:Individual
Prefix:DR
First Name:NEVILLE
Middle Name:WINSTON
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8883E NORTH SWAN ROAD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224
Mailing Address - Country:US
Mailing Address - Phone:262-417-5062
Mailing Address - Fax:414-797-4377
Practice Address - Street 1:1134 W NORTH AVE FL 2
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53205
Practice Address - Country:US
Practice Address - Phone:414-269-9660
Practice Address - Fax:414-435-3126
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37370-020207QA0401X, 207V00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100041767Medicaid