Provider Demographics
NPI:1083619951
Name:NARAYAN, DWAYNE (MD)
Entity Type:Individual
Prefix:
First Name:DWAYNE
Middle Name:
Last Name:NARAYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CAMPUS COMMONS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1535
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 NORTHWOOD DR
Practice Address - Street 2:
Practice Address - City:CENTRE
Practice Address - State:AL
Practice Address - Zip Code:35960-1023
Practice Address - Country:US
Practice Address - Phone:256-927-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC815802084P0800X
ARE-110782084P0800X
TN560522084P0800X
MDD00582932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6105444OtherMAMSI
MD3105444OtherMAMSI
MD6105444OtherMAMSI