Provider Demographics
NPI:1558434654
Name:DEAL, EDWARD R (DO)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:R
Last Name:DEAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1 FEDERAL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:848-288-6935
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER ANESTHESIA ASSOCIATES
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2425
Practice Address - Fax:856-968-8239
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB05221500207L00000X
NJMB52215207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0388336000OtherAMERIHEALTH/KEYSTONE/IBC
NJ2565944OtherUNITED HEALTH CARE
NJ60001318OtherHORIZON NJ HEALTH
NJ000567228OtherAMERIHEALTH PPO/PA BS
NJ2463504Medicaid
NJ30208OtherUNIVERISTY HEALTH PLAN
NJ010003777OtherAMERICHOICE
NJ050042667OtherRR MEDICARE
NJ0940641OtherAETNA
NJ1081262OtherHORIZON NJ HEALTH
NJP00457430OtherRR MEDICARE
E53499Medicare UPIN
NJ000567228OtherAMERIHEALTH PPO/PA BS
NJ050042667OtherRR MEDICARE