Provider Demographics
NPI:1750382388
Name:DUNCAN, GREGORY L (PHD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:L
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 JOHNS HOPKINS DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7225
Mailing Address - Country:US
Mailing Address - Phone:252-714-0155
Mailing Address - Fax:252-758-1866
Practice Address - Street 1:905 JOHNS HOPKINS DRIVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7225
Practice Address - Country:US
Practice Address - Phone:252-744-1406
Practice Address - Fax:252-744-2419
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC798103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC620004585OtherRAILROAD MEDICARE
NC6000643Medicaid
NC0333NOtherBCBS NC
NC6000643Medicaid
NC2810207BMedicare PIN