# DUANE SIBILLY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DUANE SIBILLY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043629447
- **Legal business name:** DUANE SIBILLY
- **Authorized official:** DUANE SIBILLY CSA (OWNER/OPERATOR)
- **Authorized official phone:** (301) 474-0916

## Contact information

- **Practice address:** 7744 MANDAN RD, GREENBELT, MD 20770-2166
- **Practice address phone:** (301) 474-0916
- **Mailing address:** 7744 MANDAN RD, GREENBELT, MD 20770-2166
- **Mailing address phone:** (301) 474-0916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 08/11/2014
- **Last updated:** 08/11/2014