MEDICARE: DUKE UNIVERSITY HEALTH SYSTEM, 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
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	H0015	NC

General Provider Information

NPI Number	:	1821094509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUKE UNIVERSITY HEALTH SYSTEM, INC.

Provider Business Mailing Address
First Line	:	PO BOX 110566
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27709-5566
Country	:	US
Telephone Number	:	919-620-4855
Fax Number	:	919-620-4921

Provider Business Practice Location Address
First Line	:	2301 ERWIN ROAD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27710-0001
Country	:	US
Telephone Number	:	919-684-8111
Fax Number	:	919-620-4921

Authorized Official
Title or Position	:	VP FINANCE
Name	:	JOHN STUART SMITH
Credential	:
Telephone Number	:	919-613-8995

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	09/12/2023

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