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NPI Code Detail

MEDICARE: TODD R DEVERE MD

MEDICARE: TODD R DEVERE 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
12084N0400XNeurology PhysicianMD-15371HI
22084N0400XNeurology PhysicianMD22871OR

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 : 1720083058
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD R DEVERE MD
Provider Business Mailing Address
First Line : 3288 MOANALUA RD
Second Line :
City : HONOLULU
State : HI
Zip : 96819-1469
Country : US
Telephone Number : 808-432-0000
Fax Number :
Provider Business Practice Location Address
First Line : 3288 MOANALUA RD
Second Line :
City : HONOLULU
State : HI
Zip : 96819-1469
Country : US
Telephone Number : 808-432-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 05/19/2021

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