Provider Demographics
NPI:1316927379
Name:DEAN, LOUIS ALAN (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:ALAN
Last Name:DEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-475-7163
Mailing Address - Fax:336-475-1199
Practice Address - Street 1:903 RANDOLPH ST
Practice Address - Street 2:DBA CHAIR CITH FAMILY PRACTICE AND MEDZONE
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5898
Practice Address - Country:US
Practice Address - Phone:336-475-7163
Practice Address - Fax:336-475-1199
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC26810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7928007Medicaid
NC890289PMedicaid
NC7928007Medicaid
NC205830EMedicare PIN
NC890289PMedicaid