Provider Demographics
NPI:1750425724
Name:DURACK, DAVID TULLOCH (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:TULLOCH
Last Name:DURACK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1700 WOODSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5232
Mailing Address - Country:US
Mailing Address - Phone:919-401-4848
Mailing Address - Fax:919-402-9915
Practice Address - Street 1:1700 WOODSTOCK RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5232
Practice Address - Country:US
Practice Address - Phone:919-401-4848
Practice Address - Fax:919-402-9915
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC22337207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD62777Medicare UPIN