Healthcare Provider Details

I. General information

NPI: 1295174209
Provider Name (Legal Business Name): DEVIN J CROFT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 N MAIN ST
PITTSFIELD ME
04967-3707
US

IV. Provider business mailing address

96 LAKE RIDGE DR
SIDNEY ME
04330-2103
US

V. Phone/Fax

Practice location:
  • Phone: 207-487-4063
  • Fax:
Mailing address:
  • Phone: 207-861-2998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD21137
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD21137
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: