Provider Demographics
NPI:1558010959
Name:MOTON, DAKARAI (DO)
Entity type:Individual
Prefix:
First Name:DAKARAI
Middle Name:
Last Name:MOTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:314-919-2700
Mailing Address - Fax:314-919-2777
Practice Address - Street 1:801 HAZELWEST DR
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1754
Practice Address - Country:US
Practice Address - Phone:314-949-2700
Practice Address - Fax:314-919-2777
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2025032414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine