Provider Demographics
NPI:1003476607
Name:HARRIS, DEVON ABT (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:ABT
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:EVA
Other - Last Name:ABT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:330 BROOKLINE AVE # SHAPIRO8
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5491
Mailing Address - Country:US
Mailing Address - Phone:617-667-3736
Mailing Address - Fax:617-667-7493
Practice Address - Street 1:330 BROOKLINE AVE # SHAPIRO8
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5491
Practice Address - Country:US
Practice Address - Phone:617-667-3736
Practice Address - Fax:617-667-7493
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA279550207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology