| Mark S Devore, Md Pc | |
|
22250 Providence Dr 703 Southfield MI 48075-4825 | |
| (586) 751-6034 | |
| (586) 751-6043 |
| Full Name | Mark S Devore, Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 22250 Providence Dr, Southfield, Michigan |
| Authorized Official Name and Position | Mark Devore (PRESIDENT) |
| Authorized Official Contact | 5867516034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark S Devore, Md Pc 22250 Providence Dr 703 Southfield MI 48075-4825 Ph: (586) 751-6034 | Mark S Devore, Md Pc 22250 Providence Dr 703 Southfield MI 48075-4825 Ph: (586) 751-6034 |
| NPI Number | 1396923603 |
|---|---|
| Provider Enumeration Date | 02/08/2008 |
| Last Update Date | 08/20/2014 |
| Medicare PECOS PAC ID | 5496834509 |
|---|---|
| Medicare Enrollment ID | O20080430000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396923603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MD048964 (Michigan) | Primary |
| Provider Name | Mark S Devore |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578521217 PECOS PAC ID: 3779662887 Enrollment ID: I20080430000714 |
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