MEDICARE: VIRGIL HILARN DUVERNAY MD, PHD, FACP

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	207R00000X	Internal Medicine Physician	01063909A	IN
2	207R00000X	Internal Medicine Physician	A45858	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	250470	OTHER	IN	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000549587	OTHER	IN	ANTHEM PIN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285681056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGIL HILARN DUVERNAY MD, PHD, FACP

Provider Business Mailing Address
First Line	:	PO BOX 5040
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95966-0040
Country	:	US
Telephone Number	:	918-528-5268
Fax Number	:	918-770-0058

Provider Business Practice Location Address
First Line	:	2450 ORO DAM BLVD E
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95966-6052
Country	:	US
Telephone Number	:	530-712-2171
Fax Number	:	530-712-2149

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	10/08/2019

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Directions to “ VIRGIL HILARN DUVERNAY MD, PHD, FACP” Practice Location

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