MEDICARE: MR. ROBERT DEVIES PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1651	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	620000842	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000130007	OTHER	OH	ANTHEM
4	457398000	OTHER	OH	MAGELLAN

General Provider Information

NPI Number	:	1457410144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT DEVIES PHD

Provider Business Mailing Address
First Line	:	4572 DRESSLER RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2546
Country	:	US
Telephone Number	:	330-493-4220
Fax Number	:	330-493-8850

Provider Business Practice Location Address
First Line	:	4572 DRESSLER RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2546
Country	:	US
Telephone Number	:	330-493-4220
Fax Number	:	330-493-8850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. ROBERT DEVIES PHD” Practice Location

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