Provider Demographics
NPI:1912521709
Name:DEASE, NAIMAH
Entity Type:Individual
Prefix:
First Name:NAIMAH
Middle Name:
Last Name:DEASE
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 1:363 CEDAR KNOLL CIR # 980257
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-6603
Mailing Address - Country:US
Mailing Address - Phone:704-221-2678
Mailing Address - Fax:
Practice Address - Street 1:VCUHS DEPT OF EMERGENCY MEDICINE RESIDENCY, 980401
Practice Address - Street 2:1250 E. MARSHALL STREET
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0401
Practice Address - Country:US
Practice Address - Phone:804-828-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC314622207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine