Provider Demographics
NPI:1952398612
Name:DUNCAN, SCOTT C (MD PA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:999 E BASSE RD
Mailing Address - Street 2:#105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1801
Mailing Address - Country:US
Mailing Address - Phone:210-824-7001
Mailing Address - Fax:210-824-8840
Practice Address - Street 1:999 E BASSE RD
Practice Address - Street 2:#105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1801
Practice Address - Country:US
Practice Address - Phone:210-824-7001
Practice Address - Fax:210-824-8840
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9425207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U1210OtherBLUE CROSS BLUE SHIELD
B87593Medicare UPIN
TX8F0766Medicare ID - Type Unspecified