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Individual

DEAN L MAYNARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3601 SW 160TH AVE, SUITE 250, MIRAMAR, FL 33027-6308
(954) 399-4645
(855) 855-2792
Mailing address
2610 HOSPITAL RD, GOLDSBORO, NC 27534-9423
(919) 731-4809

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2009-00027
NC
207Q00000X
Family Medicine Physician
Primary
26848
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
268481
SC
Enumeration date
08/13/2006
Last updated
06/28/2016
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