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Individual

MR. DEAN DANIEL MARTURELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1500 ROSS CLARK CIR, DOTHAN, AL 36301-4754
(334) 793-2663
(334) 836-2248
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-2248

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
339259-8906
UT
363A00000X
Physician Assistant
Primary
PA.893
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
168820
AL
05
168908
AL
01
511-56940
BCBS OF ALABAMA
AL
01
511-56943
BCBS OF ALABAMA
AL
Enumeration date
10/20/2011
Last updated
02/25/2015
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