Provider Demographics
NPI:1497854285
Name:MARSON, DEAN R (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:R
Last Name:MARSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 GUARDIAN AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4322
Mailing Address - Country:US
Mailing Address - Phone:252-247-2101
Mailing Address - Fax:252-247-4675
Practice Address - Street 1:306 MEDICAL PARK CT
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4346
Practice Address - Country:US
Practice Address - Phone:252-247-2101
Practice Address - Fax:252-247-4675
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200101367208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89130R6Medicaid
NC89130R6Medicaid
NC2296948Medicare PIN