Healthcare Provider Details

I. General information

NPI: 1952374290
Provider Name (Legal Business Name): GREGORY P DUFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4409 NW ANDERSON HILL RD
SILVERDALE WA
98383-6807
US

IV. Provider business mailing address

4409 NW ANDERSON HILL RD
SILVERDALE WA
98383-6807
US

V. Phone/Fax

Practice location:
  • Phone: 360-698-6630
  • Fax: 360-825-6536
Mailing address:
  • Phone: 360-698-6630
  • Fax: 360-825-6536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD00034439
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: