Kenneth R Devellis, MD
Surgery in Medford, Massachusetts
1528007515- Practice location
- 92 High St, Suite 32, Medford, MA 02155-3850
- Phone
- 781-395-5250
- Fax
- —
- Last updated
- August 16, 2011
Kenneth R Devellis is a Surgery based in Medford, MA. Kenneth R Devellis practices in Medford, MA and has the professional credentials of MD. The NPI Number for Kenneth R Devellis is 1528007515 and holds a License No. 40819 (MA). The current practice location address for Kenneth R Devellis is 92 High St, Suite 32, Medford, MA 02155-3850 and can be reached out via phone at 781-395-5250.
Provider Profile Details
- NPI Number
- 1528007515
- Provider Name
- Kenneth R Devellis
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 92 High St, Suite 32, Medford, MA 02155-3850
- Phone Number
- 781-395-5250
- Primary Taxonomy
- Surgery · 208600000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- June 5, 2006
- Last Update Date
- August 16, 2011
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 92 High St
Suite 32
Medford, MA 02155-3850 - City
- Medford
- State
- Massachusetts
- Zip
- 02155-3850
- Phone Number
- 781-395-5250
Provider Business Mailing Address Details
- Address
- 92 High St
Suite 32
Medford, MA 02155-3850 - City
- Medford
- State
- MA
- Zip
- 02155-3850
- Phone Number
- 781-395-5250
License Information
- License Number
- 40819
- License State
- MA
- Taxonomy
- Surgery · 208600000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kenneth R Devellis, MD?
The NPI number of Kenneth R Devellis, MD is 1528007515. It was assigned on June 5, 2006 and is currently active in the NPPES registry.
What is the specialty of Kenneth R Devellis, MD?
Kenneth R Devellis, MD is registered under the primary taxonomy Surgery (code 208600000X), licensed in MA under license number 40819.
Where does Kenneth R Devellis, MD practice?
The practice location is 92 High St, Suite 32, Medford, MA 02155-3850. The office can be reached at 781-395-5250 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1528007515 directly on the NPPES registry website.