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General NPI Number Information
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NPI Number | 1467783027
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Entity Type | Organization
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Legal Business Name | DR. MICHAEL DUCHAMP DO, PA
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 930 W RALPH HALL PKWY SUITE 108
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City | ROCKWALL
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State | TX
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Zip | 75032-6665
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Country | US
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Telephone | 972-772-8577
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Fax | 972-772-8575
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Provider Business Mailing Address
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Address Line | PO BOX 506
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City | ROCKWALL
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State | TX
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Zip | 75087-0506
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Country | US
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Telephone | 972-772-8577
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Fax | 972-772-8575
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL DAVID DUCHAMP
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Credential | D.O.
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Telephone | 972-772-8577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DOH9894
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License Number State | TX
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