MEDICARE: MARK THOMAS DEAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	DO.2748	AL

General Provider Information

NPI Number	:	1144840224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK THOMAS DEAN DO

Provider Business Mailing Address
First Line	:	S: 625 19TH STREET SOUTH BIRMINGHAM AL 35249
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35249-4444
Country	:	US
Telephone Number	:	205-934-4793
Fax Number	:

Provider Business Practice Location Address
First Line	:	S: 625 19TH STREET SOUTH BIRMINGHAM AL 35249
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35249-0001
Country	:	US
Telephone Number	:	205-934-4793
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2020
Last Update Date	:	03/05/2026

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