Healthcare Provider Details
I. General information
NPI: 1134548233
Provider Name (Legal Business Name): JOSHUA MCDEVITT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/16/2014
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 BREWSTER BLVD NMRTC CAMP LEJEUNE
CAMP LEJEUNE NC
28547
US
IV. Provider business mailing address
100 BREWSTER BLVD NMRTC CAMP LEJEUNE
CAMP LEJEUNE NC
28547
US
V. Phone/Fax
- Phone: 910-450-4700
- Fax:
- Phone: 910-450-4700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | 0101264913 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 0101264913 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: