Healthcare Provider Details

I. General information

NPI: 1356677611
Provider Name (Legal Business Name): PETER JOSEPH DUQUETTE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

IV. Provider business mailing address

UNIVERSITY OF NORTH CAROLINA CAMPUS BOX 7255
CHAPEL HILL NC
27599-7255
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-4845
  • Fax: 919-966-2230
Mailing address:
  • Phone: 919-966-4845
  • Fax: 919-966-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3865
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3865
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: