Individual
DR. RICHARD ALAN DEVORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
630 W MAIN ST STE 300, WILMINGTON, OH 45177-2172
(937) 283-9800
(937) 283-9794
Mailing address
610 W MAIN ST, WILMINGTON, OH 45177-2125
(937) 283-9845
(937) 283-9839
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
150885
OR
207Y00000X
Otolaryngology Physician
Primary
35-058294
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040015410
RR MEDICARE
OH
05
—
0802804
—
OH
Enumeration date
05/31/2005
Last updated
09/10/2020
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