Healthcare Provider Details

I. General information

NPI: 1912908047
Provider Name (Legal Business Name): DWAYNE L PLATT JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/03/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 ORD STREET
SALISBURY PA
15558-0066
US

IV. Provider business mailing address

231 ORD STREET
SALISBURY PA
15558-0066
US

V. Phone/Fax

Practice location:
  • Phone: 814-662-2755
  • Fax: 814-662-2001
Mailing address:
  • Phone: 814-662-2755
  • Fax: 814-662-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD072282L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD072282L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: