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NPI Code Detail

MEDICARE: ALFRED AINSLEY DURHAM M.D.

MEDICARE: ALFRED AINSLEY DURHAM 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
1207X00000XOrthopaedic Surgery Physician0101033332VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00290785OTHERVAMEDICARE RAILROAD

General Provider Information

NPI Number : 1306841887
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALFRED AINSLEY DURHAM M.D.
Provider Business Mailing Address
First Line : 1802 BRAEBURN DR
Second Line :
City : SALEM
State : VA
Zip : 24153-7357
Country : US
Telephone Number : 540-772-3530
Fax Number : 540-776-2036
Provider Business Practice Location Address
First Line : 1802 BRAEBURN DR
Second Line :
City : SALEM
State : VA
Zip : 24153-7357
Country : US
Telephone Number : 540-772-3530
Fax Number : 540-776-2036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 11/29/2007

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