Healthcare Provider Details

I. General information

NPI: 1699190827
Provider Name (Legal Business Name): DEVIN DONOHOE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2014
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 NORTH MAIN ST
FLORENCE MA
01062
US

IV. Provider business mailing address

45 PRINCETON TER APT 45
GREENFIELD MA
01301-9637
US

V. Phone/Fax

Practice location:
  • Phone: 413-582-5555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA7921
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA7921
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: