Provider Demographics
NPI:1497240782
Name:SPITTEL, DEVIN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:MICHAEL
Last Name:SPITTEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 278
Mailing Address - Street 2:
Mailing Address - City:MAPLE RIDGE
Mailing Address - State:BC
Mailing Address - Zip Code:V2X7G2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:#205-11743 224TH STREET
Practice Address - Street 2:
Practice Address - City:MAPLE RIDGE
Practice Address - State:BC
Practice Address - Zip Code:V2X6A4
Practice Address - Country:CA
Practice Address - Phone:604-467-5030
Practice Address - Fax:604-467-5008
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR186587208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty