Provider Demographics
NPI:1649242447
Name:MCDEVITT, NEIL SHAW (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:SHAW
Last Name:MCDEVITT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 277869
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7869
Mailing Address - Country:US
Mailing Address - Phone:843-875-8994
Mailing Address - Fax:843-875-8981
Practice Address - Street 1:109 BURTON AVE
Practice Address - Street 2:SUITE E
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8117
Practice Address - Country:US
Practice Address - Phone:843-875-8994
Practice Address - Fax:843-875-8981
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2013-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC23168208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC020054127OtherRAILROAD MEDICARE
SC231680Medicaid
H62101Medicare UPIN