Basic Information
| Provider Information | |||||||||
| NPI: | 1871732859 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DURANY | ||||||||
| FirstName: | NILDA | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2640 HAMSTROM RD | ||||||||
| Address2: | |||||||||
| City: | PORTAGE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463683832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2197624423 | ||||||||
| FaxNumber: | 2197633120 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 E CLIFTY DR | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 472504621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122742742 | ||||||||
| FaxNumber: | 5022220029 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2009 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 01029781A | IN | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.