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General NPI Number Information
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NPI Number | 1164485470
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Entity Type | Individual
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Provider Name | JOHN EDWARD DEAVER MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 1505 W SHERMAN AVE
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City | VINELAND
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State | NJ
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Zip | 08360-7059
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Country | US
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Telephone | 302-465-1959
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Fax |
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Provider Business Mailing Address
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Address Line | 7324 GREGORY BLVD
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City | MILFORD
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State | DE
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Zip | 19963-3945
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Country | US
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Telephone | 302-465-1959
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2010008638
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C1-0010768
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 158011
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License Number State | NY
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