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General NPI Number Information
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NPI Number | 1851393201
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Entity Type | Individual
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Provider Name | PENELOPE DUVALL MD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 2246 GEORGE WASHINGTON MEMORIAL HWY
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City | HAYES
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State | VA
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Zip | 23072-3559
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Country | US
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Telephone | 804-642-6171
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Fax |
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Provider Business Mailing Address
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Address Line | 4458 THORNCROFT DR
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City | GLEN ALLEN
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State | VA
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Zip | 23060-3335
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Country | US
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Telephone | 215-272-7500
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 079470
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | PENDING
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME92567
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License Number State | FL
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