Individual
MR. GEORGE JOSEPH DEVITA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11050 MOUNT BELVEDERE BLVD, USA MEDDAC ATTN: CREDENTIALS, FORT DRUM, NY 13602-5438
(315) 772-4025
(315) 772-9498
Mailing address
27082 WADDINGHAM RD, EVANS MILLS, NY 13637-3277
(315) 772-3225
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
12/22/2005
Last updated
07/08/2007
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