=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952309544
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID P DEVER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2005
-----------------------------------------------------
Last Update Date | 04/18/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 995 SENATOR KEATING BLVD. BLDG. E STE 330
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14618-2775
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-232-2980
-----------------------------------------------------
Fax | 585-232-6522
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8000 DEPT. 441
-----------------------------------------------------
City | BUFFALO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14267-0002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-844-5600
-----------------------------------------------------
Fax | 716-844-5750
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | 146560
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------