Provider Demographics
NPI:1619943743
Name:VARIAN, DEAN W (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:W
Last Name:VARIAN
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 1:6303 MAPLETON ST SE
Mailing Address - Street 2:
Mailing Address - City:EAST CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44730-9566
Mailing Address - Country:US
Mailing Address - Phone:330-488-0911
Mailing Address - Fax:330-488-8025
Practice Address - Street 1:2725 LINCOLN ST. E
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44707
Practice Address - Country:US
Practice Address - Phone:330-454-2000
Practice Address - Fax:330-499-8025
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3507824207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0516614Medicaid
OHCO3704Medicare UPIN
OHVA7010151Medicare PIN