| Organization Name: | DUANE SIBILLY |
| NPI Number: | 1043629447 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DUANE SIBILLY (OWNER/OPERATOR) |
| Mailing Address: | 7744 Mandan Rd Greenbelt |
| State: | MD US |
| Postal Code: | 207702166 |
| Phone Number: | 3014740916 |
| Fax Number: | |
| NPI Enumeration Date: | 08/11/2014 |
| NPI Last Update Date: | 08/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |