Individual
DR. DWAYNE ALAN MAULTSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7154 N UNIVERSITY DR, #316, TAMARAC, FL 33321-2916
(954) 720-3188
(954) 586-2589
Mailing address
PO BOX 640996, MIAMI, FL 33164
(954) 720-3188
(954) 586-2589
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME106616
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200083200A
—
OK
Enumeration date
06/22/2006
Last updated
01/31/2017
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