MEDICARE: DR. DANIEL JOSEPH DUVALL 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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	0000021997	TN

General Provider Information

NPI Number	:	1770580011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JOSEPH DUVALL M.D.

Provider Business Mailing Address
First Line	:	6328 SEA HAVEN DR
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-3138
Country	:	US
Telephone Number	:	423-842-2136
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 PINE ST
Second Line	:	6-C
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2520
Country	:	US
Telephone Number	:	423-763-3038
Fax Number	:

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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