Provider Demographics
NPI:1538521331
Name:BOYD, DUSTON WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:DUSTON
Middle Name:WAYNE
Last Name:BOYD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5033 REUTER ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3361
Mailing Address - Country:US
Mailing Address - Phone:225-405-6888
Mailing Address - Fax:
Practice Address - Street 1:9421 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3485
Practice Address - Country:US
Practice Address - Phone:313-462-4960
Practice Address - Fax:313-338-3196
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301117431207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program