Provider Demographics
NPI:1255103537
Name:MCBEAN, DIAN ANNAMARIE
Entity type:Individual
Prefix:
First Name:DIAN
Middle Name:ANNAMARIE
Last Name:MCBEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 CROWN POINTE PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7702
Mailing Address - Country:US
Mailing Address - Phone:470-289-2489
Mailing Address - Fax:
Practice Address - Street 1:1050 CROWN POINTE PKWY STE 500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-7702
Practice Address - Country:US
Practice Address - Phone:470-289-2489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty