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General NPI Number Information
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NPI Number | 1255334934
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Entity Type | Individual
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Provider Name | DWAYNE E PATTERSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 7101 CREEDMOOR RD STE 109
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City | RALEIGH
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State | NC
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Zip | 27613-1682
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Country | US
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Telephone | 919-324-1704
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Fax | 919-516-0070
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Provider Business Mailing Address
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Address Line | 7101 CREEDMOOR RD STE 109
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City | RALEIGH
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State | NC
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Zip | 27613-1682
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Country | US
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Telephone | 919-324-1704
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Fax | 919-516-0070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 9700702
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 97-00702
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License Number State | NC
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