MEDICARE: TIMOTHY DEVINE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	22940	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CA7030	OTHER	WV	RAILROAD MEDICARE GROUP #
3	P00623101	OTHER	WV	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316144033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY DEVINE MD

Provider Business Mailing Address
First Line	:	PO BOX 780
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26507-0780
Country	:	US
Telephone Number	:	304-293-7401
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 TAYLOR ST
Second Line	:
City	:	HARPERS FERRY
State	:	WV
Zip	:	25425-9519
Country	:	US
Telephone Number	:	304-535-6343
Fax Number	:	304-535-6618

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	12/09/2024

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Directions to “ TIMOTHY DEVINE MD” Practice Location

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