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Individual

CHARLES JOSEPH DEVINE III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
434 WASHINGTON ST., BOYDTON, VA 23917
(434) 738-6815
(434) 738-6295
Mailing address
434 WASHINGTON ST., PO BOX 560, BOYDTON, VA 23917
(434) 738-6815
(434) 738-6295

Taxonomy

Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
0101034518
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5811007
VA
Enumeration date
02/15/2007
Last updated
07/08/2007
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