MEDICARE: TIMOTHY F. MCDEVITT, M.D. INC

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	261QS0132X	Ophthalmologic Surgery Clinic/Center	MD7864	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E94267	OTHER	HI	HMSA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639339013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY F. MCDEVITT, M.D. INC

Provider Business Mailing Address
First Line	:	1380 LUSITANA ST
Second Line	:	SUITE 708
City	:	HONOLULU
State	:	HI
Zip	:	96813-2449
Country	:	US
Telephone Number	:	808-599-4755
Fax Number	:	808-599-5397

Provider Business Practice Location Address
First Line	:	1380 LUSITANA ST
Second Line	:	SUITE 708
City	:	HONOLULU
State	:	HI
Zip	:	96813-2449
Country	:	US
Telephone Number	:	808-599-4755
Fax Number	:	808-599-5397

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. TIMOTHY F MCDEVITT
Credential	:	M.D.
Telephone Number	:	808-599-4755

Provider Enumeration Date	:	06/10/2008
Last Update Date	:	06/10/2008

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