Provider Demographics
NPI:1306800867
Name:DUCK, G. BRYAN (MD)
Entity type:Individual
Prefix:DR
First Name:G.
Middle Name:BRYAN
Last Name:DUCK
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 1:9101 STONY POINT DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235
Mailing Address - Country:US
Mailing Address - Phone:804-330-9105
Mailing Address - Fax:804-287-6119
Practice Address - Street 1:9101 STONY POINT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235
Practice Address - Country:US
Practice Address - Phone:804-330-9105
Practice Address - Fax:804-287-6119
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101 032021208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA24387OtherALLIANCE
VA59289OtherSOUTHERN HEALTH
VA007590792Medicaid
VA340001590OtherRAILROAD MEDICARE
VA56379OtherCARENET
VA2106OtherCIGNA
VA7904719OtherAETNA HMO
VAC01241OtherMEDICARE GROUP #
VACL9160OtherRAILROAD MEDICARE GROUP #
VA1900469OtherUNITED HEALTHCARE
VA4063365OtherAETNA PPO
VA45721OtherSENTARA FAMILY CARE
VA641999000-00OtherQUALCHOICE
VA223284518OtherTRICARE
VAC01241OtherMEDICARE GROUP #
VA45721OtherSENTARA FAMILY CARE
VA56379OtherCARENET