Healthcare Provider Details

I. General information

NPI: 1285565259
Provider Name (Legal Business Name): DUNCAN MAITLAND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-0001
US

IV. Provider business mailing address

435 TINSMAN AVE
WILLIAMSPORT PA
17701-3920
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6211
  • Fax:
Mailing address:
  • Phone: 570-560-1148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number678633
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: