Provider Demographics
NPI:1861490351
Name:DEVINE, ARTHUR WILLIAM JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:WILLIAM
Last Name:DEVINE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3178
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52406-3178
Mailing Address - Country:US
Mailing Address - Phone:319-398-1583
Mailing Address - Fax:319-399-2085
Practice Address - Street 1:202 10TH STREET SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2404
Practice Address - Country:US
Practice Address - Phone:319-363-8171
Practice Address - Fax:319-363-3172
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22151208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN56514OtherBLUE CROSS/BLUE SHIELD
IA4193003Medicaid
IN56514OtherBLUE CROSS/BLUE SHIELD
IA56514Medicare ID - Type Unspecified