Provider Demographics
NPI:1275665754
Name:MAYORS, DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:
Last Name:MAYORS
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 1:386 BEECHNUT HL
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-8313
Mailing Address - Country:US
Mailing Address - Phone:330-666-2751
Mailing Address - Fax:
Practice Address - Street 1:201 5TH ST NE STE 10
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3017
Practice Address - Country:US
Practice Address - Phone:330-753-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35039796174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0458884Medicaid
OH0458884Medicaid
OHA79212Medicare UPIN