Provider Demographics
NPI:1497009187
Name:SWEET, DEVIN P (IDC)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:P
Last Name:SWEET
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5813 CHINQUAPIN PKWY
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2555
Mailing Address - Country:US
Mailing Address - Phone:847-406-8526
Mailing Address - Fax:
Practice Address - Street 1:5813 CHINQUAPIN PKWY
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2555
Practice Address - Country:US
Practice Address - Phone:847-406-8526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman