Provider Demographics
NPI:1134256381
Name:STEPHENS, DEAN HUGH (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:HUGH
Last Name:STEPHENS
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 1:5400 WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6234
Mailing Address - Country:US
Mailing Address - Phone:912-349-4227
Mailing Address - Fax:912-349-4457
Practice Address - Street 1:5400 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404
Practice Address - Country:US
Practice Address - Phone:912-349-4227
Practice Address - Fax:912-349-4457
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065898207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003110134HMedicaid
GAP01234322OtherRAILROAD MEDICARE
GA003110134GMedicaid
GA202I669922Medicare PIN