DWAIN GAVIN MCCALL (NPI# 1578058194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578058194 |
| Entity Type | Individual |
| Full Name | DWAIN GAVIN MCCALL |
| Credential | PA-C |
| Practice Address |
C1722 Tagaytay Drive Fort Bragg NC 28310-5318 |
| Mailing Address |
2817 Reilly St Fort Bragg NC 28310-7394 |
| Practice Telephone | 2706432229 |
| Mailing Telephone | 9106322229 |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2019-12-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Street Address |
C1722 TAGAYTAY DRIVE |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720530355 | Robert Holly | Military Health Care Provider | 7606 Reilly Rd, Bldg 2, Fort Bragg, NC 28307 | 2016-10-31 |
| 1720602824 | James Harter | Military Health Care Provider | 2817 Reilly Rd, Fort Bragg, NC 28310-7301 | 2020-06-04 |
| 1669093233 | Nathan Jeffrey Palmer | Military Health Care Provider | 1722 Gruber Rd, Fort Bragg, NC 28310-7901 | 2020-05-05 |
| 1770118358 | John Commerford | Military Health Care Provider | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-03-04 |
| 1518590983 | James Ma | Military Health Care Provider | 2817 Reilly Road, Womack Army Medical Center, Fort Bragg, NC 28310 | 2020-02-13 |
| 1992261580 | Ahsan Salim Mir | Military Health Care Provider | 1722 Tagatay Dr, Fort Bragg, NC 28307 | 2019-02-19 |
| 1518440411 | Jacob Michael Alexander | Military Health Care Provider | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2018-09-07 |
| 1992288724 | Kabita Bista | Military Health Care Provider | Womack Army Medical Center, Fort Bragg, NC 28310-0001 | 2018-09-07 |
| 1053863803 | Karen Devane Jeffers | Military Health Care Provider | 2817 Reilly St, Womack Army Medical Center, Fort Bragg, NC 28310-7324 | 2016-10-27 |
| 1073866083 | Chelsea Wrenn | Military Health Care Provider | 2817 Reilly St, Womack Army Medical Center, Fort Bragg, NC 28310-7324 | 2012-10-16 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
Please comment or provide details below to improve the information on DWAIN GAVIN MCCALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.