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General NPI Number Information
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NPI Number | 1790219483
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Entity Type | Individual
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Provider Name | DWAYNE ROY WILLIAMS II RDMS, RVT
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Gender | Male
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 200 VETERANS AVE
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City | BECKLEY
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State | WV
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Zip | 25801-6444
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Country | US
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Telephone | 304-255-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 PAINT CREEK RD
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City | MOUNT HOPE
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State | WV
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Zip | 25880-6575
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Country | US
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Telephone |
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Fax |
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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 | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 117465
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number | 117465
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License Number State |
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