Individual
DIANA K DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5925
(770) 237-3475
(770) 237-3756
Mailing address
1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5925
(770) 237-3475
(770) 237-3756
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002262
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002412A
—
GA
01
—
970027445
RAILROAD MEDICARE
GA
Enumeration date
07/28/2005
Last updated
01/29/2008
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