Basic Information
Provider Information
NPI: 1710187919
EntityType: 2
ReplacementNPI:  
OrganizationName: DUKE UNIVERSITY HEALTH SYSTEM
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 110566
Address2:  
City: DURHAM
State: NC
PostalCode: 277095566
CountryCode: US
TelephoneNumber: 9196204855
FaxNumber: 9196204921
Practice Location
Address1: 2301 ERWIN ROAD
Address2: DEPT OF OB/GYN
City: DURHAM
State: NC
PostalCode: 277100001
CountryCode: US
TelephoneNumber: 9196848111
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2007
LastUpdateDate: 07/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SMITH
AuthorizedOfficialFirstName: JOHN
AuthorizedOfficialMiddleName: STUART
AuthorizedOfficialTitleorPosition: VP, FINANCE
AuthorizedOfficialTelephone: 9196138995
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282NW0100X141675NCY HospitalsGeneral Acute Care HospitalWomen

No ID Information.


Home