Provider Demographics
NPI:1578263364
Name:ARTIS, DEVEN
Entity Type:Individual
Prefix:
First Name:DEVEN
Middle Name:
Last Name:ARTIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3122 BARRED OWL LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2746
Mailing Address - Country:US
Mailing Address - Phone:757-235-0490
Mailing Address - Fax:
Practice Address - Street 1:3122 BARRED OWL LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-2746
Practice Address - Country:US
Practice Address - Phone:757-235-0490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies