Provider Demographics
NPI:1154390714
Name:DUNCAN, CONRAD J (MD)
Entity type:Individual
Prefix:
First Name:CONRAD
Middle Name:J
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5421
Mailing Address - Country:US
Mailing Address - Phone:443-738-2872
Mailing Address - Fax:443-738-2713
Practice Address - Street 1:3407 WILKENS AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5072
Practice Address - Country:US
Practice Address - Phone:410-644-0929
Practice Address - Fax:410-664-4338
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2014-02-03
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Provider Licenses
StateLicense IDTaxonomies
MDD0045495207VG0400X, 2088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD005525500Medicaid
F69992Medicare UPIN
MD290283YZUMedicare PIN