Provider Demographics
NPI:1164608865
Name:DEAN, WENDY KATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:KATHERINE
Last Name:DEAN
Suffix:
Gender:F
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:PO BOX 50
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:17081
Mailing Address - Country:US
Mailing Address - Phone:717-241-9595
Mailing Address - Fax:717-960-0303
Practice Address - Street 1:26 STATE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015
Practice Address - Country:US
Practice Address - Phone:717-241-9595
Practice Address - Fax:717-960-0303
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4269052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIF66781Medicare UPIN