Provider Demographics
NPI:1376514968
Name:DEVERS, PAUL DIX (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DIX
Last Name:DEVERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7000 ATRIUM WAY
Mailing Address - Street 2:STE 6
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3917
Mailing Address - Country:US
Mailing Address - Phone:609-668-6797
Mailing Address - Fax:609-668-6798
Practice Address - Street 1:1 SHEFFIELD DR
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBUS
Practice Address - State:NJ
Practice Address - Zip Code:08022-9549
Practice Address - Country:US
Practice Address - Phone:609-668-6797
Practice Address - Fax:609-668-6798
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2020-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07834000207Q00000X
PAMD070258L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0103292Medicaid
NJ0103292Medicaid