Provider Demographics
NPI:1154499010
Name:DEAN, WALTER ANDREW (PA-C)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:ANDREW
Last Name:DEAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 SW 6TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1707
Mailing Address - Country:US
Mailing Address - Phone:785-354-8518
Mailing Address - Fax:785-354-1255
Practice Address - Street 1:5820 LAMAR AVE STE 200
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2655
Practice Address - Country:US
Practice Address - Phone:913-631-6330
Practice Address - Fax:913-631-6222
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS15-01003363AM0700X
MO2006028785363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P96780Medicare UPIN