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NPI Code Detail

MEDICARE: DR. KATHLEEN FERGUSON DEVANEY M.D.

MEDICARE: DR. KATHLEEN FERGUSON DEVANEY M.D.
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
1208000000XPediatrics Physician74065MA

Other Identifiers

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

General Provider Information

NPI Number : 1336147214
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN FERGUSON DEVANEY M.D.
Provider Business Mailing Address
First Line : 140 HAVERHILL ST
Second Line :
City : ANDOVER
State : MA
Zip : 01810-1504
Country : US
Telephone Number : 978-475-4522
Fax Number : 978-475-6531
Provider Business Practice Location Address
First Line : 140 HAVERHILL ST
Second Line :
City : ANDOVER
State : MA
Zip : 01810-1504
Country : US
Telephone Number : 978-475-4522
Fax Number : 978-475-6531
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 07/08/2007

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Directions to “ DR. KATHLEEN FERGUSON DEVANEY M.D.” Practice Location

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