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NPI Code Detail

MEDICARE: MARK EDWIN DUFF

MEDICARE: MARK EDWIN DUFF
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
1163WW0000XWound Care Registered Nurse0001185611VA

General Provider Information

NPI Number : 1457210684
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK EDWIN DUFF
Provider Business Mailing Address
First Line : 6151 RENOIR LN
Second Line :
City : ROANOKE
State : VA
Zip : 24018-5298
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1970 ROANOKE BLVD
Second Line :
City : SALEM
State : VA
Zip : 24153-6404
Country : US
Telephone Number : 540-982-2463
Fax Number : 540-244-1944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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