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Individual
DR. DEAN WOODROW SHANDY
Active
Individual
DR. DEAN WOODROW SHANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
O-1419
ID
2084P0800X
Psychiatry Physician
OT015224
PA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
58.030415
OH
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
O-1419
ID
208D00000X
General Practice Physician
OS017403
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103243408
—
PA
01
—
16721C
WY STATE LIC
WY
01
—
MED-PHYS-COM-LIC-135
MT STATE LICENSE
MT
01
—
O-1419
ID STATE MED LIC
ID
01
—
OS017403
STATE LICENSE NUMBER
PA
Enumeration date
05/07/2013
Last updated
04/09/2026
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