Healthcare Provider Details

I. General information

NPI: 1144431180
Provider Name (Legal Business Name): CLAYTON L DEAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SAINT PAUL ST MARYLAND SPINE CENTER
BALTIMORE MD
21202-2102
US

IV. Provider business mailing address

301 SAINT PAUL ST MARYLAND SPINE CENTER
BALTIMORE MD
21202-2102
US

V. Phone/Fax

Practice location:
  • Phone: 410-539-3434
  • Fax: 410-539-3550
Mailing address:
  • Phone: 410-539-3434
  • Fax: 410-539-3550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberD0068886
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: