Provider Demographics
NPI:1023137916
Name:DUNCAN, MATTHEW WINFRED (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WINFRED
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MATTHEW
Other - Middle Name:WINFRED
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2059 CAMDEN AVE
Mailing Address - Street 2:331
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2024
Mailing Address - Country:US
Mailing Address - Phone:408-926-4775
Mailing Address - Fax:408-369-8020
Practice Address - Street 1:1101 S WINCHESTER BLVD
Practice Address - Street 2:SUITE I-207
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3901
Practice Address - Country:US
Practice Address - Phone:408-248-5665
Practice Address - Fax:408-248-5224
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC32967173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine