Provider Demographics
NPI:1518958735
Name:DEAN, STEVEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:DEAN
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 1:38815 DEQUINDRE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-6810
Mailing Address - Country:US
Mailing Address - Phone:248-528-1010
Mailing Address - Fax:248-528-0202
Practice Address - Street 1:38815 DEQUINDRE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-6810
Practice Address - Country:US
Practice Address - Phone:248-528-1010
Practice Address - Fax:248-528-0202
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301054538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F51331Medicare UPIN
MIMI6405001Medicare PIN