Provider Demographics
NPI:1689875346
Name:DEVRIES, KATHERINE M (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:M
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:860 OMNI BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:408 16TH STREET
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:VA
Practice Address - Zip Code:23181
Practice Address - Country:US
Practice Address - Phone:804-843-3131
Practice Address - Fax:804-843-3222
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2021-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0116018390207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA020861T78Medicare PIN