Provider Demographics
NPI:1740945583
Name:DUONG, DAVID D (CNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:D
Last Name:DUONG
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 NW WASHINGTON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-6381
Mailing Address - Country:US
Mailing Address - Phone:951-231-3106
Mailing Address - Fax:
Practice Address - Street 1:840 NW WASHINGTON BLVD STE C
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-6381
Practice Address - Country:US
Practice Address - Phone:513-737-7246
Practice Address - Fax:513-737-6601
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-06
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0030084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty