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General NPI Number Information
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NPI Number | 1548064108
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Entity Type | Individual
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Provider Name | ANNIE DUKE MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 430 INDIANA AVE APT 337
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-3242
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Country | US
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Telephone | 253-569-2893
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Fax |
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Provider Business Mailing Address
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Address Line | 420 DELAWARE ST SE, MMC 913
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City | MINNEAPOLIS
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State | MN
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Zip | 55455-0341
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Country | US
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Telephone | 253-569-2893
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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