Rodemack, Dean William

Rodemack, Dean William is an individual health care provider with primary practice located at 401 W Camas Ave , Fairfield ID 83327. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Rodemack, Dean William can be contacted via phone (208) 764-2611.

Contact Information

Primary practice address
401 W Camas Ave Fairfield ID 83327
Phone: (208) 764-2611
Fax: (208) 933-4921
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA60245393 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-1020 Idaho

Profile Details

NPI number 1548543424
LBN Legal business name Rodemack, Dean William
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2011
Last updated Apr 8th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548543424 NPPES
Washington MEDICAID 158543424
Washington Other 0285610

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