Individual
DWAYNE NATHAN DAMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1212 WEBER RD, FARMINGTON, MO 63640-3325
(573) 701-7215
(573) 701-7117
Mailing address
16 MAHOGANY RUN, FARMINGTON, MO 63640-7785
(573) 366-1077
(573) 701-7117
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
113439
MO
207Q00000X
Family Medicine Physician
Primary
113439
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
244893913
—
MO
Enumeration date
05/17/2006
Last updated
09/09/2013
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