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Individual

MR. DEVAN LOUIS DEPAUW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1227 EAST RUSHOLME ST., DAVENPORT, IA 52803
(563) 421-1000
Mailing address
5601 EASTERN AVE. P2, DAVENPORT, IA 52807
(309) 945-2695

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
090689
IA

Other

Enumeration date
01/26/2018
Last updated
01/26/2018
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