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General NPI Number Information
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NPI Number | 1942391693
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Entity Type | Organization
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Legal Business Name | PAUL A. DEVORE MD PC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 4203 QUEENSBURY RD
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City | HYATTSVILLE
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State | MD
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Zip | 20781-1435
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Country | US
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Telephone | 301-454-0801
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Fax | 301-454-0810
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Provider Business Mailing Address
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Address Line | 4203 QUEENSBURY RD
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City | HYATTSVILLE
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State | MD
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Zip | 20781-1435
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Country | US
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Telephone | 301-454-0801
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Fax | 301-454-0810
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. PAUL A DEVORE
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Credential | MD
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Telephone | 301-454-0801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | D001852
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License Number State | MD
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