Healthcare Provider Details

I. General information

NPI: 1386576221
Provider Name (Legal Business Name): DUY-TAN NGO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2016 MAPLEMERE CT
DURHAM NC
27703-6795
US

IV. Provider business mailing address

2016 MAPLEMERE CT
DURHAM NC
27703-6795
US

V. Phone/Fax

Practice location:
  • Phone: 919-909-0891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number335577
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number335577
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: