Doctor Name: | DR. EVANDER DUCK |
NPI Number: | 1679673636 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D.,M.S. |
License Number: | MA060290 |
Business Practice Address: | 495 Iron Bridge Rd Suite 7 Freehold, NJ - 077283069 |
Business Phone Number: | 7327808477 |
Business Fax Number: | 7327802979 |
Mailing Address: | 11 Shira Ln, MANALAPAN |
State: | NJ |
Postal Code: | 077268801 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/22/2006 |
NPI Last Update Date: | 12/07/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA060290 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |