Provider Demographics
NPI:1093786972
Name:DEVANNY, SCOTT R (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:DEVANNY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:246 PLEASANT ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-224-1223
Mailing Address - Fax:603-228-7133
Practice Address - Street 1:246 PLEASANT ST
Practice Address - Street 2:SUITE 106
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-1223
Practice Address - Fax:603-228-7133
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2015-01-12
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Provider Licenses
StateLicense IDTaxonomies
NH10203207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077568Medicaid
G72438Medicare UPIN
NH30200784Medicaid