MEDICARE: H MICHAEL DUKE MD INC.

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	207N00000X	Dermatology Physician

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	:	1194841924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H MICHAEL DUKE MD INC.

Provider Business Mailing Address
First Line	:	6210 N MAIN ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-3111
Country	:	US
Telephone Number	:	937-275-6647
Fax Number	:	937-275-7643

Provider Business Practice Location Address
First Line	:	6210 N MAIN ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-3111
Country	:	US
Telephone Number	:	937-275-6647
Fax Number	:	937-275-7643

Authorized Official
Title or Position	:	OWNER
Name	:	HENRY MICHAEL DUKE
Credential	:	MD
Telephone Number	:	937-275-6647

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	10/21/2010

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