Mittman, Dean L
Mittman, Dean L is an individual health care provider with primary practice located at 2115 S Fremont Ave Suite 2100, Springfield MO 65804-2239. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Mittman, Dean L can be contacted via phone (417) 820-7720.Contact Information
Primary practice address
2115 S Fremont Ave Suite 2100
Springfield MO 65804-2239
Phone: (417) 820-7720
Fax: (417) 820-7223
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 111705 | Missouri |
Profile Details
| NPI number | 1043359292 |
|---|---|
| LBN Legal business name | Mittman, Dean L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 5th, 2007 |
| Last updated | May 9th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043359292 | NPPES |
| Missouri | Other | 110426 | MO MEDICARE |
| Missouri | Other | 81287 | MO MEDICARE |
| Missouri | MEDICAID | 208573014 | MO MEDICARE |
| Missouri | MEDICAID | 142569001 | MO MEDICARE |
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