Provider Demographics
NPI:1235441593
Name:DEVRIES, LINDSAY BETH BAKER (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:BETH BAKER
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:BETH
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5085 GOLDEN EYE DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5516
Mailing Address - Country:US
Mailing Address - Phone:810-275-3191
Mailing Address - Fax:
Practice Address - Street 1:5430 FREDERICKSBURG RD
Practice Address - Street 2:SUITE 508
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3539
Practice Address - Country:US
Practice Address - Phone:210-541-8281
Practice Address - Fax:210-541-9123
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096932208000000X, 2080N0001X
TXP41542080N0001X
TXQ84612080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics