Healthcare Provider Details

I. General information

NPI: 1588529747
Provider Name (Legal Business Name): DEAN W RAYMOND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57467 WATERWORKS ST
CALUMET MI
49913-1258
US

IV. Provider business mailing address

101 E MARY STREET BESSEMER, 49911
BESSMER MI
49911
US

V. Phone/Fax

Practice location:
  • Phone: 906-364-1556
  • Fax:
Mailing address:
  • Phone: 906-364-1556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberNA
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: