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General NPI Number Information
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NPI Number | 1902022668
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Entity Type | Individual
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Provider Name | DWAYNE ALLEN PIERCE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0001
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Country | US
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Telephone | 336-716-6978
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Fax |
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Provider Business Mailing Address
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Address Line | 4112 GLENCOVE CT
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City | WINSTON SALEM
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State | NC
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Zip | 27106-4782
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Country | US
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Telephone | 336-760-2416
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16658
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 018945
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License Number State | GA
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