Healthcare Provider Details

I. General information

NPI: 1992138671
Provider Name (Legal Business Name): CHRISTOPHER PIERCE DEANS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 HIGHLAND DR
WASHINGTON NC
27889-3405
US

IV. Provider business mailing address

120 WILLIAM PENN PLZ
DURHAM NC
27704-2150
US

V. Phone/Fax

Practice location:
  • Phone: 252-946-6513
  • Fax: 252-948-0808
Mailing address:
  • Phone: 919-220-5255
  • Fax: 919-313-1276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-04391
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: