Healthcare Provider Details

I. General information

NPI: 1275604381
Provider Name (Legal Business Name): MARY Y. DUAN DIPL. AC. (NCCAOM)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MAPLE GROVE LN
ROCKVILLE MD
20850-6692
US

IV. Provider business mailing address

1221 MAPLE GROVE LN
ROCKVILLE MD
20850-6692
US

V. Phone/Fax

Practice location:
  • Phone: 301-947-7688
  • Fax:
Mailing address:
  • Phone: 301-947-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberU01409
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: