Damba, Dwayne Nathan

Damba, Dwayne Nathan is an individual health care provider with primary practice located at 1212 Weber Rd , Farmington MO 63640-3325. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Damba, Dwayne Nathan can be contacted via phone (573) 701-7215.

Contact Information

Primary practice address
1212 Weber Rd Farmington MO 63640-3325
Phone: (573) 701-7215
Fax: (573) 701-7117
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 113439 Missouri
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 113439 Missouri

Profile Details

NPI number 1194777193
LBN Legal business name Damba, Dwayne Nathan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Sep 9th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194777193 NPPES
Missouri MEDICAID 244893913

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