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Contact Information

DUSTIN R MAYNE, DO
2900 DOOLITTLE DR
ELLSWORTH AFB, SD57706
 Phone: 937-641-3000
 Fax: 937-641-5931
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for DUSTIN R MAYNE · (Male)

NPI # 1780045427
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/08/2016
Last updated 08/05/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NE License # 1780
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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