MEDICARE: ROGER H DUDA MD

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	2084P0800X	Psychiatry Physician	MD431832	PA

General Provider Information

NPI Number	:	1770630691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER H DUDA MD

Provider Business Mailing Address
First Line	:	2451 MIDTOWN AVE APT 1327
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-1438
Country	:	US
Telephone Number	:	610-999-6174
Fax Number	:

Provider Business Practice Location Address
First Line	:	2451 MIDTOWN AVE APT 1327
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-1438
Country	:	US
Telephone Number	:	610-999-6174
Fax Number	:

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	05/20/2016

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