Healthcare Provider Details
I. General information
NPI: 1871548032
Provider Name (Legal Business Name): DEAN FERRIS MARKHAM JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/24/2006
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2390 HEMBY LN
GREENVILLE NC
27834-3775
US
IV. Provider business mailing address
PO BOX 751069
CHARLOTTE NC
28275-1069
US
V. Phone/Fax
- Phone: 252-744-4500
- Fax: 252-744-3472
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | ME76278 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | 2014-00074 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: