Healthcare Provider Details

I. General information

NPI: 1003476607
Provider Name (Legal Business Name): DEVON ABT HARRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEVON EVA ABT MD

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE KIRSTEIN 3
BOSTON MA
02215-5491
US

IV. Provider business mailing address

330 BROOKLINE AVE KIRSTEIN 3
BOSTON MA
02215-5491
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-3736
  • Fax: 617-667-7493
Mailing address:
  • Phone: 617-667-3736
  • Fax: 617-667-7493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number279550
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: