Provider Demographics
NPI:1467429951
Name:KANE, DEAN PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:PHILIP
Last Name:KANE
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 1:8 BELLCHASE CT
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1300
Mailing Address - Country:US
Mailing Address - Phone:410-486-6006
Mailing Address - Fax:
Practice Address - Street 1:1 RESERVOIR COURT
Practice Address - Street 2:SUITE 201
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21205
Practice Address - Country:US
Practice Address - Phone:410-602-3322
Practice Address - Fax:410-602-8363
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0026662174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4860Medicare ID - Type Unspecified
MDD77611Medicare UPIN