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General NPI Number Information
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NPI Number | 1164491296
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Entity Type | Individual
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Provider Name | DEAN A PAGE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 900 W TEMPLE AVE STE 2500
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City | EFFINGHAM
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State | IL
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Zip | 62401-2121
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Country | US
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Telephone | 217-540-2350
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 WOODSIDE EXECUTIVE CT
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City | AIKEN
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State | SC
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Zip | 29803-3831
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Country | US
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Telephone | 803-642-0277
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Fax | 803-641-4277
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 21914
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 036157974
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License Number State | IL
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