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NPI Code Detail

MEDICARE: JOHN B. DEVINE II M.D. INC.

MEDICARE: JOHN B. DEVINE II 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
1208800000XUrology Physician

General Provider Information

NPI Number : 1740268200
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN B. DEVINE II M.D. INC.
Provider Business Mailing Address
First Line : 676 S BROADWAY ST
Second Line : SUITE 102
City : AKRON
State : OH
Zip : 44311-1059
Country : US
Telephone Number : 440-777-6017
Fax Number : 440-777-6940
Provider Business Practice Location Address
First Line : 676 S BROADWAY ST
Second Line : SUITE 102
City : AKRON
State : OH
Zip : 44311-1059
Country : US
Telephone Number : 330-344-4005
Fax Number : 330-344-0005
Authorized Official
Title or Position : PRESIDENT
Name : JOHN B. DEVINE II
Credential : M.D.
Telephone Number : 330-344-4005
Provider Enumeration Date : 01/05/2006
Last Update Date : 04/01/2008

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