Maryott, Dwayne Brian

Maryott, Dwayne Brian is an sole proprietor health care provider with primary practice located at 1850 W Arlington Blvd , Greenville NC 27834-5704. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Maryott, Dwayne Brian can be contacted via phone (252) 413-6202.

Contact Information

Primary practice address
1850 W Arlington Blvd Greenville NC 27834-5704
Phone: (252) 413-6202
Fax: (252) 758-8333
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-01043 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X MA001621L Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 004628-1 New York

Profile Details

NPI number 1801876040
LBN Legal business name Maryott, Dwayne Brian
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 21st, 2006
Last updated May 20th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801876040 NPPES
North Carolina MEDICAID 8102826

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