Provider Demographics
NPI:1568458073
Name:EDELL, DEAN S (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:S
Last Name:EDELL
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-765-5500
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:8200 CONSTANTIN BLVD FL 3
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3481
Practice Address - Country:US
Practice Address - Phone:225-765-5500
Practice Address - Fax:225-765-1899
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09610R2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1965162Medicaid
LAF49072Medicare UPIN
LA5R620Medicare ID - Type Unspecified