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NPI Code Detail

MEDICARE: DWAYNE KING

MEDICARE: DWAYNE KING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1891653465
Entity Type Code : Individual
Provider Name (Legal Business Name) : DWAYNE KING
Provider Business Mailing Address
First Line : 1440 E EMPIRE AVE
Second Line :
City : BENTON HARBOR
State : MI
Zip : 49022-2020
Country : US
Telephone Number : 269-487-9826
Fax Number :
Provider Business Practice Location Address
First Line : 1440 E EMPIRE AVE
Second Line :
City : BENTON HARBOR
State : MI
Zip : 49022-2020
Country : US
Telephone Number : 269-487-9826
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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Directions to “ DWAYNE KING ” Practice Location

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