Provider Demographics
NPI:1215067509
Name:DUNCAN, PHILLIP B (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:B
Last Name:DUNCAN
Suffix:
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 1:281 E HUNDRED RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2613
Mailing Address - Country:US
Mailing Address - Phone:804-530-5178
Mailing Address - Fax:804-530-5185
Practice Address - Street 1:281 E HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2613
Practice Address - Country:US
Practice Address - Phone:804-530-5178
Practice Address - Fax:804-530-5185
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035649174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005817986Medicaid
VAA92104Medicare UPIN
A92104Medicare UPIN
VA060000091Medicare ID - Type Unspecified