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Individual

DR. JOHN EDWARD DEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1505 W SHERMAN AVE, VINELAND, NJ 08360-7059
(302) 465-1959
Mailing address
7324 GREGORY BLVD, MILFORD, DE 19963-3945
(302) 465-1959

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
158011
NY
207V00000X
Obstetrics & Gynecology Physician
2010008638
MO
207V00000X
Obstetrics & Gynecology Physician
Primary
C1-0010768
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01071732
NY
05
1164485470
MO
01
431560263
TRICARE WEST
01
P00826737
RAILROAD MEDICARE CB9013
Enumeration date
04/08/2006
Last updated
10/06/2020
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