Healthcare Provider Details

I. General information

NPI: 1508069352
Provider Name (Legal Business Name): DEAN KYER MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 GREENWAY AVE SUITE 100
CHARLESTON WV
25309-1426
US

IV. Provider business mailing address

414 GREENWAY AVE SUITE 100
CHARLESTON WV
25309-1426
US

V. Phone/Fax

Practice location:
  • Phone: 304-766-4444
  • Fax: 304-766-4447
Mailing address:
  • Phone: 304-766-4444
  • Fax: 304-766-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number19792
License Number StateWV

VIII. Authorized Official

Name: DR. DEAN KYER
Title or Position: OWNER
Credential: MD
Phone: 304-766-4444