Provider Demographics
NPI:1659376135
Name:DEAN, EDWARD N (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:N
Last Name:DEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2900 12TH AVE N
Mailing Address - Street 2:STE 204E
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0164
Mailing Address - Country:US
Mailing Address - Phone:406-237-5001
Mailing Address - Fax:406-237-5010
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:STE 204E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0164
Practice Address - Country:US
Practice Address - Phone:406-237-5001
Practice Address - Fax:406-237-5010
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2011-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT9805207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT36363Medicaid
MT36363Medicaid
C03106Medicare UPIN