Provider Demographics
NPI:1215378450
Name:BLAND, DEVIN S (DPM)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:S
Last Name:BLAND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:DEVIN
Other - Middle Name:S
Other - Last Name:BLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:301 E BETHANY HOME RD STE C172
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-0008
Mailing Address - Country:US
Mailing Address - Phone:602-477-9422
Mailing Address - Fax:602-675-0924
Practice Address - Street 1:301 E BETHANY HOME RD STE 172
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1263
Practice Address - Country:US
Practice Address - Phone:602-477-9422
Practice Address - Fax:602-675-0924
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ000839213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist