Provider Demographics
NPI:1760564124
Name:DEANE, LYNNE PENDLETON (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:PENDLETON
Last Name:DEANE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:211 DESOTA DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-7110
Mailing Address - Country:US
Mailing Address - Phone:804-754-7178
Mailing Address - Fax:804-287-6466
Practice Address - Street 1:28 WESTHAMPTON WAY
Practice Address - Street 2:SPECIAL PROGRAMS BUILDING
Practice Address - City:UNIVERSITY OF RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23173-0001
Practice Address - Country:US
Practice Address - Phone:804-289-8064
Practice Address - Fax:804-287-6466
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101035863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VABO5070Medicare UPIN