Provider Demographics
NPI:1568455665
Name:DEAN, JOHN NEWELL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:NEWELL
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 1:147 ASHELAND AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4013
Mailing Address - Country:US
Mailing Address - Phone:828-258-1188
Mailing Address - Fax:828-251-1801
Practice Address - Street 1:147 ASHELAND AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4013
Practice Address - Country:US
Practice Address - Phone:828-258-1188
Practice Address - Fax:828-251-1801
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC60162207R00000X
NC22906207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0470555OtherUNITED HEALTHCARE
NC7928004Medicaid
NC28004OtherBCBS
110132171OtherRAILROAD MEDICARE
NC0470555OtherUNITED HEALTHCARE
NC7928004Medicaid
NC28004OtherBCBS