Healthcare Provider Details

I. General information

NPI: 1801476510
Provider Name (Legal Business Name): DEVIN POTTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 NEALY AVE
HAMPTON VA
23665-2040
US

IV. Provider business mailing address

4494 GRACE CHAPEL RD
GRANITE FALLS NC
28630-9367
US

V. Phone/Fax

Practice location:
  • Phone: 757-225-7630
  • Fax:
Mailing address:
  • Phone: 828-381-3734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number100782
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: