Provider Demographics
NPI:1245619972
Name:BEAN, DEVIN LYNDE (PA)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:LYNDE
Last Name:BEAN
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:300A FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1280
Practice Address - Country:US
Practice Address - Phone:508-973-2211
Practice Address - Fax:508-973-1105
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2020-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAPA5354363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical