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General NPI Number Information
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NPI Number | 1194709840
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Entity Type | Individual
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Provider Name | GEORGE T DUVALL III MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2312 20TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-4109
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Country | US
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Telephone | 772-562-1275
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Fax | 772-562-4630
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Provider Business Mailing Address
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Address Line | 2312 20TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-4109
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Country | US
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Telephone | 772-562-1275
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Fax | 772-562-4630
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | ME0027970
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 38607
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 24530
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License Number State | AZ
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