Provider Demographics
NPI:1710580683
Name:MCAFEE, DWAYNE B
Entity Type:Individual
Prefix:
First Name:DWAYNE
Middle Name:B
Last Name:MCAFEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 W A ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4850
Mailing Address - Country:US
Mailing Address - Phone:510-690-8192
Mailing Address - Fax:
Practice Address - Street 1:258 W A ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4850
Practice Address - Country:US
Practice Address - Phone:510-690-8192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator