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NPI Code Detail

MEDICARE: DR. MARC DEAN NEW MD

MEDICARE: DR. MARC DEAN NEW MD
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
1207RG0100XGastroenterology Physician19975SC
2207RG0100XGastroenterology Physician47028OK
3207RG0100XGastroenterology PhysicianDR.0070209CO
4207RG0100XGastroenterology Physician70083TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831170612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARC DEAN NEW MD
Provider Business Mailing Address
First Line : PO BOX 800022
Second Line :
City : KANSAS CITY
State : MO
Zip : 64180-0022
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4401 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3413
Country : US
Telephone Number : 405-552-0133
Fax Number : 405-552-5122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 01/27/2026

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