Provider Demographics
NPI:1518294016
Name:STEELE, DWAYNE CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:DWAYNE
Middle Name:CHRISTOPHER
Last Name:STEELE
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 1:1050 W PERIMETER RD
Mailing Address - Street 2:
Mailing Address - City:JB ANDREWS
Mailing Address - State:MD
Mailing Address - Zip Code:20762-6601
Mailing Address - Country:US
Mailing Address - Phone:240-612-1757
Mailing Address - Fax:
Practice Address - Street 1:4525 FULTON INDUSTRIAL BLVD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30336-1919
Practice Address - Country:US
Practice Address - Phone:404-691-4999
Practice Address - Fax:404-691-4993
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249329208D00000X
MN57650208D00000X
GA077147208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice