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General NPI Number Information
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NPI Number | 1619029691
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Entity Type | Individual
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Provider Name | PHILIP D DEAN MD
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 511 E BOONESLICK RD
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City | WARRENTON
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State | MO
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Zip | 63383-2011
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Country | US
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Telephone | 636-456-8370
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Fax | 636-456-8370
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Provider Business Mailing Address
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Address Line | 511 E BOONESLICK RD PO BOX 709
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City | WARRENTON
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State | MO
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Zip | 63383-2011
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Country | US
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Telephone | 636-456-8370
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Fax | 636-456-8370
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | R6G74
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | R6G74
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | R6G74
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License Number State | MO
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