MEDICARE: DUONG M DUONG 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	207R00000X	Internal Medicine Physician	MD00017755	WA

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	:	1831154293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUONG M DUONG MD

Provider Business Mailing Address
First Line	:	PO BOX 98886
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98496-8886
Country	:	US
Telephone Number	:	253-589-6484
Fax Number	:	253-984-1079

Provider Business Practice Location Address
First Line	:	4901 108TH ST SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3724
Country	:	US
Telephone Number	:	206-682-2101
Fax Number	:	206-682-2089

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	09/05/2019

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Directions to “ DUONG M DUONG MD” Practice Location

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