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General NPI Number Information
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NPI Number | 1740542232
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Entity Type | Individual
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Provider Name | H JEDIDIAH DUENSING DO
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Gender | Male
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Dates
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Enumeration Date | 06/12/2012
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 5401 FALLOWATER LN STE E
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City | ROANOKE
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State | VA
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Zip | 24018-0949
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Country | US
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Telephone | 540-315-1668
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Fax | 855-998-8574
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Provider Business Mailing Address
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Address Line | PO BOX 639295 DEPT 93394
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City | CINCINNATI
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State | OH
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Zip | 45263-9295
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Country | US
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Telephone | 540-315-1668
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Fax | 855-998-8574
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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 | T1278
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102204298
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License Number State | VA
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