Provider Demographics
NPI:1780692277
Name:DUNCAN, HARRY EARL JR (MD)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:EARL
Last Name:DUNCAN
Suffix:JR
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 1:3100 MACCORKLE AVENUE
Mailing Address - Street 2:SUITE 509
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1226
Mailing Address - Country:US
Mailing Address - Phone:304-342-0821
Mailing Address - Fax:304-345-6679
Practice Address - Street 1:3100 MACCORKLE AVENUE
Practice Address - Street 2:SUITE 509
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1226
Practice Address - Country:US
Practice Address - Phone:304-342-0821
Practice Address - Fax:304-345-6679
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10533207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0082977000Medicaid
WV0082977000Medicaid
0470931Medicare ID - Type Unspecified