Individual
MR. DWAYNE EPPY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(267) 752-2690
Mailing address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(267) 752-2690
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA055385
PA
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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