Healthcare Provider Details

I. General information

NPI: 1093633174
Provider Name (Legal Business Name): ADAM SCOTT DUNCKEL RDN, LD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 S DOUGLASS ST APT 203
COLUMBUS OH
43205-1376
US

IV. Provider business mailing address

66 S DOUGLASS ST APT 203
COLUMBUS OH
43205-1376
US

V. Phone/Fax

Practice location:
  • Phone: 419-389-7778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: