Healthcare Provider Details

I. General information

NPI: 1013142025
Provider Name (Legal Business Name): DUNCAN PAUL YODER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRESHAM DR STE 8620
NORFOLK VA
23507-1904
US

IV. Provider business mailing address

600 GRESHAM DR STE 8620
NORFOLK VA
23507-1904
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-1600
  • Fax: 757-625-0433
Mailing address:
  • Phone: 757-395-1600
  • Fax: 757-625-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMTL001073
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number0101261045
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: