Provider Demographics
NPI:1740445170
Name:DEVITT, JEFFREY WALTER JR (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WALTER
Last Name:DEVITT
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:26025 LAHSER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2606
Mailing Address - Country:US
Mailing Address - Phone:248-663-1900
Mailing Address - Fax:248-663-1901
Practice Address - Street 1:26025 LAHSER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2606
Practice Address - Country:US
Practice Address - Phone:248-663-1900
Practice Address - Fax:248-663-1901
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2014-02-19
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Provider Licenses
StateLicense IDTaxonomies
MI4301092153207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301092153OtherMICHIGAN LICENSE