MEDICARE: MICHAEL SHAYNE DUNCAN PHYSICAL THERAPIST

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	225100000X	Physical Therapist	PT23812	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT23812	OTHER	CA	PHYSICAL THERAPY LICENSE

General Provider Information

NPI Number	:	1871618298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SHAYNE DUNCAN PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	224 ELSIE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-5508
Country	:	US
Telephone Number	:	415-920-9211
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 ELSIE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-5508
Country	:	US
Telephone Number	:	415-920-9211
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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