MEDICARE: DUANE ANTHONY MCKINNEY DPM

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
1	213ES0131X	Foot Surgery Podiatrist	01331	MD

General Provider Information

NPI Number	:	1245260413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUANE ANTHONY MCKINNEY DPM

Provider Business Mailing Address
First Line	:	7708 HANOVER PKWY
Second Line	:	APT 201
City	:	GREENBELT
State	:	MD
Zip	:	20770-2633
Country	:	US
Telephone Number	:	301-982-2525
Fax Number	:	301-262-6486

Provider Business Practice Location Address
First Line	:	7404 EXECUTIVE PL
Second Line	:	SUITE 501
City	:	LANHAM
State	:	MD
Zip	:	20706-2268
Country	:	US
Telephone Number	:	301-262-6314
Fax Number	:	301-262-6486

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/09/2007

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