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Individual

STEPHEN M DEVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
19620
WI
207RC0000X
Cardiovascular Disease Physician
35657
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30326500
WI
Enumeration date
06/15/2005
Last updated
08/20/2014
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