Individual
MARK DEVORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22250 PROVIDENCE DR, 703, SOUTHFIELD, MI 48075-6214
(248) 569-1770
Mailing address
22250 PROVIDENCE DR STE 606, SOUTHFIELD, MI 48075-6214
(248) 569-1770
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD048964
MI
Other
Enumeration date
05/03/2006
Last updated
05/11/2021
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