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1063417764

NPI Code Detail

MEDICARE: DEAN S MCGAUGHEY III MD

MEDICARE: DEAN S MCGAUGHEY III MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	DR.0069214	CO
2	207RH0003X	Hematology & Oncology Physician	0101225787	VA
3	207RX0202X	Medical Oncology Physician	DR.0069214	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110202413	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	26040	OTHER	VA	OPTIMA

General Provider Information

NPI Number	:	1063417764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEAN S MCGAUGHEY III MD

Provider Business Mailing Address
First Line	:	6251 E VIRGINIA BEACH BLVD STE 200
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-2800
Country	:	US
Telephone Number	:	757-213-5700
Fax Number	:	757-213-5701

Provider Business Practice Location Address
First Line	:	5900 LAKE WRIGHT DR
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-1871
Country	:	US
Telephone Number	:	757-466-8683
Fax Number	:	757-466-8892

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	09/18/2024

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Directions to “ DEAN S MCGAUGHEY III MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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