1093031072 NPI number — NINA NIAMKEY DUKE M.D.

Table of content: NINA NIAMKEY DUKE M.D. (NPI 1093031072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093031072 NPI number — NINA NIAMKEY DUKE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUKE
Provider First Name:
NINA
Provider Middle Name:
NIAMKEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NIAMKEY
Provider Other First Name:
NINA
Provider Other Middle Name:
AMA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093031072
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 37215
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21297-3215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-476-3670
Provider Business Mailing Address Fax Number:
202-476-4741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 S 7TH AVE
Provider Second Line Business Practice Location Address:
SUITE 3170
Provider Business Practice Location Address City Name:
WEST READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19611-1410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-898-9380
Provider Business Practice Location Address Fax Number:
610-478-1170
Provider Enumeration Date:
04/15/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD041522 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)