Provider Demographics
NPI:1558535765
Name:DEAN, ERIN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:DEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:PREWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1310 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4441
Mailing Address - Country:US
Mailing Address - Phone:330-475-1631
Mailing Address - Fax:330-475-1634
Practice Address - Street 1:1310 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4441
Practice Address - Country:US
Practice Address - Phone:330-475-1631
Practice Address - Fax:330-475-1634
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.095229207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0082293Medicaid
OHH201830Medicare PIN