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NPI Code Detail

MEDICARE: JOHN M. DUCHAK III MD

MEDICARE: JOHN M. DUCHAK III 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
1207RC0000XCardiovascular Disease Physician35.064642OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110077875OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841269057
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN M. DUCHAK III MD
Provider Business Mailing Address
First Line : 4000 MIAMISBURG CENTERVILLE RD STE 100
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-7615
Country : US
Telephone Number : 937-866-0637
Fax Number : 937-866-6713
Provider Business Practice Location Address
First Line : 1126 S MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45409-2687
Country : US
Telephone Number : 937-223-3053
Fax Number : 937-463-1765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 02/01/2021

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