Individual provider · NPI-1

Dwayne Nathan Damba, DO

Emergency Medicine · Farmington, MO

NPI number1194777193
StatusActive
Last updated in NPPESSep 22, 2026

Details

NPI
1194777193
Entity type
Individual (NPI-1)
Name
Dwayne Nathan Damba
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
May 17, 2006
Certification date
Sep 22, 2026
Last updated
Sep 22, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency Medicine81130MNYes
207P00000X Emergency Medicine113439MO
207Q00000X Family Medicine113439MO

Practice location

1212 Weber Rd
Farmington, MO 63640-3325

Phone 573-701-7215 · Fax 573-701-7117

Mailing address

16 Mahogany Run
Farmington, MO 63640-7785

Phone 573-366-1077 · Fax 573-701-7117

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