1689698813 NPI number — NANCY A. BIERMAN-DEAR M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689698813 NPI number — NANCY A. BIERMAN-DEAR M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

BIERMAN-DEAR

Provider First Name:

NANCY

Provider Middle Name:

A.

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

DEAR

Provider Other First Name:

NANCY

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

M.D.

Provider Other Last Name Type Code:

1

NPI Number:

1689698813

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/11/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

5000 COX RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

GLEN ALLEN

Provider Business Mailing Address State Name:

VA

Provider Business Mailing Address Postal Code:

23060-9263

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

804-968-5700

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

630 MANTUA PIKE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

WOODBURY

Provider Business Practice Location Address State Name:

NJ

Provider Business Practice Location Address Postal Code:

08096-3233

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

856-812-2220

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

07/27/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Q00000X , with the licence number:  D0089814 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207Q00000X , with the licence number: 0101270230 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207Q00000X , with the licence number: 25MA05361400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 0513488000 . This is a "AMERIHEALTH HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: K4942 . This is a "HORIZON" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 679434 . This is a "AMERIHEALTH PPO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 4581407 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 1156257 . This is a "HORIZON MERCY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 221820210 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 01000218301 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 1K9950 . This is a "HEALTH NET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 221820210 . This is a "ATLANTICARE HMO/PPO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 3217 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".