Provider Demographics
NPI:1336182245
Name:DEAN, ZANE WAJI M (MD)
Entity Type:Individual
Prefix:DR
First Name:ZANE
Middle Name:WAJI M
Last Name:DEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WAJEEHUDDIN
Other - Middle Name:
Other - Last Name:MOHAMMED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1003 BELLEFONTAINE AVE STE 200
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1803
Practice Address - Country:US
Practice Address - Phone:419-224-5915
Practice Address - Fax:419-224-5918
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061909A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0216684Medicaid
IN200904310AMedicaid
INM400031607Medicare PIN