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General NPI Number Information
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NPI Number | 1023095924
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Entity Type | Individual
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Provider Name | BARRY KENT DIDUCH MD
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Gender | Male
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 78 MEDICAL CENTER DRIVE HEART & VASCULAR 2ND FLOOR
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2332
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Country | US
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Telephone | 540-332-5595
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Fax | 540-332-5596
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Provider Business Mailing Address
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Address Line | PO BOX 388
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City | FISHERSVILLE
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State | VA
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Zip | 22939-0388
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Country | US
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Telephone | 540-932-5162
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Fax | 540-932-5875
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101-052714
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License Number State | VA
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