MEDICARE: DR. SAMUEL T DUNCAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	51424	NJ
2	207W00000X	Ophthalmology Physician	51424	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063419810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL T DUNCAN M.D.

Provider Business Mailing Address
First Line	:	378 MARION ST
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-4118
Country	:	US
Telephone Number	:	973-762-4996
Fax Number	:	908-688-8829

Provider Business Practice Location Address
First Line	:	2040 MILLBURN AVE
Second Line	:	SUITE 303
City	:	MAPLEWOOD
State	:	NJ
Zip	:	07040-3726
Country	:	US
Telephone Number	:	973-762-4996
Fax Number	:	973-762-4955

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	05/22/2015

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