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Individual

BRIAN THOMAS MCDEVITT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-7196
Mailing address
2620 PRATT ST, PHILADELPHIA, PA 19137-1738
(215) 779-8454

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN573428
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN573428
PA

Other

Enumeration date
08/08/2016
Last updated
11/03/2016
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