Individual
JEANAE ELYSE DEDIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 648-8111
Mailing address
753 MCDUFFIE DR, MYRTLE BEACH, SC 29588-5452
(973) 647-8128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13303
NC
Other
Enumeration date
08/18/2023
Last updated
01/18/2024
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