MEDICARE: DR. DAVID J DUVAL 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	A68089	CA

General Provider Information

NPI Number	:	1356335137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID J DUVAL M.D.

Provider Business Mailing Address
First Line	:	1921 ELODIE LN
Second Line	:
City	:	GULF BREEZE
State	:	FL
Zip	:	32563-8962
Country	:	US
Telephone Number	:	850-916-1516
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 BOATNER RD
Second Line	:	SUITE 114
City	:	EGLIN AFB
State	:	FL
Zip	:	32542-1391
Country	:	US
Telephone Number	:	850-883-8272
Fax Number	:	850-883-8240

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	07/08/2007

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