Individual
AUDREY DEVINE
Active
Individual
AUDREY DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01085094A
IN
207RR0500X
Rheumatology Physician
Primary
01085094A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11019470A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266180L38
MEDICARE
—
05
—
300064418
—
IN
Enumeration date
06/18/2017
Last updated
03/08/2024
Update your record
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