1881713121 NPI number — DR. ADJOA B DUKER M.D., M.P.H.

Table of content: DR. ADJOA B DUKER M.D., M.P.H. (NPI 1881713121)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881713121 NPI number — DR. ADJOA B DUKER M.D., M.P.H.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUKER
Provider First Name:
ADJOA
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., M.P.H.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUKER
Provider Other First Name:
ADJOA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1881713121
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2045 PEACHTREE RD NE STE 310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30309-1407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-222-9914
Provider Business Mailing Address Fax Number:
678-280-7307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1475 MONTREAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCKER
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30084-6922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-292-6606
Provider Business Practice Location Address Fax Number:
678-280-7307
Provider Enumeration Date:
03/28/2007

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: 207Q00000X , with the licence number:  239794 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 96789 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00695941 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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