Provider Demographics
NPI:1104788355
Name:AUSTIN, ANTOINE DWAYNE
Entity type:Individual
Prefix:MR
First Name:ANTOINE
Middle Name:DWAYNE
Last Name:AUSTIN
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 1:1655 CATALPA RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1006
Mailing Address - Country:US
Mailing Address - Phone:216-618-6106
Mailing Address - Fax:
Practice Address - Street 1:1655 CATALPA RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1006
Practice Address - Country:US
Practice Address - Phone:216-618-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty