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Individual

DR. MICHAEL DAVID DEVEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
308 KINGSLEY LAKE DR STE 802, SAINT AUGUSTINE, FL 32092-3046
(904) 342-0438
Mailing address
308 KINGSLEY LAKE DR STE 802, SAINT AUGUSTINE, FL 32092-3046
(904) 342-0438

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
ME131282
FL
208VP0000X
Pain Medicine Physician
ME131282
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
ME131282
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13880301
CAQH
Enumeration date
04/02/2013
Last updated
05/21/2024
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