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NPI Code Detail

MEDICARE: MSDDO INC

MEDICARE: MSDDO INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1225762313
Entity Type Code : Organization
Provider Name (Legal Business Name) : MSDDO INC
Provider Business Mailing Address
First Line : 12156 LILAC HEIGHTS CT
Second Line :
City : VALLEY CENTER
State : CA
Zip : 92082-3319
Country : US
Telephone Number : 858-951-8087
Fax Number :
Provider Business Practice Location Address
First Line : 12156 LILAC HEIGHTS CT
Second Line :
City : VALLEY CENTER
State : CA
Zip : 92082-3319
Country : US
Telephone Number : 858-951-8087
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MICHAEL S DUFFY SR.
Credential : DO
Telephone Number : 858-951-8087
Provider Enumeration Date : 07/13/2022
Last Update Date : 07/21/2022

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Directions to “MSDDO INC ” Practice Location

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