Provider Demographics
NPI:1528043999
Name:DEVRIES, KARIE LIN (MD)
Entity Type:Individual
Prefix:
First Name:KARIE
Middle Name:LIN
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 764
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1628
Mailing Address - Country:US
Mailing Address - Phone:617-965-7800
Mailing Address - Fax:617-965-4581
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 764
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1628
Practice Address - Country:US
Practice Address - Phone:617-965-7800
Practice Address - Fax:617-965-4581
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2008-06-05
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Provider Licenses
StateLicense IDTaxonomies
MA152756207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0701334OtherUNITED HEALTHCARE
S023506OtherCHAMPUS
0025501OtherNEIGHBORHOOD HEALTH
043200332OtherSTANDARD TAX ID
37704OtherHEALTHY START
131410OtherHPHC
MA152756OtherTUFTS HEALTH PLAN
160057179OtherRAILROAD MEDICARE
B20430403OtherCIGNA
MAJ18034OtherBCBS
152756OtherTUFTS
MA3171345Medicaid
1643449OtherHEALTHSOURCE MA
2608539OtherAETNA US HEALTHCARE
G14042Medicare UPIN
37704OtherHEALTHY START