Basic Information
| Provider Information | |||||||||
| NPI: | 1033413547 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNCAN | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | OSBORNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8235 HYANNIS PORT DR | ||||||||
| Address2: | APT 2B | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454581779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9377236119 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 405 W GRAND AVE | ||||||||
| Address2: | C/O MEDICAL EDUCATION | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454054720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9377233248 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2010 | ||||||||
| LastUpdateDate: | 03/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 58.003696 | OH | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 36197 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.