Provider Demographics
NPI:1053393975
Name:DUERDEN, MARC E (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:E
Last Name:DUERDEN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:7950 N SHADELAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2692
Mailing Address - Country:US
Mailing Address - Phone:317-588-7130
Mailing Address - Fax:317-588-7150
Practice Address - Street 1:7950 N SHADELAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2692
Practice Address - Country:US
Practice Address - Phone:317-588-7130
Practice Address - Fax:317-588-7150
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01041371A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200009000AMedicaid
INF55146Medicare UPIN
IN200009000AMedicaid