Provider Demographics
NPI:1255480729
Name:DEEMS, ROBERT WAYNE (DC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WAYNE
Last Name:DEEMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-2361
Mailing Address - Country:US
Mailing Address - Phone:740-423-8220
Mailing Address - Fax:740-423-9670
Practice Address - Street 1:903 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-2361
Practice Address - Country:US
Practice Address - Phone:740-423-8220
Practice Address - Fax:740-423-9670
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3001111N00000X
WV740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311735772-002OtherBLUE CROSS OF IDAHO #
WV2201004-000Medicaid
OH2205590Medicaid
OH7824235OtherAETNA US HEALTHCARE #
OH311735772-00OtherOHIO WORKER'S COMP #
WV2201004-000Medicaid