Individual
DR. JOHN G DEVINE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 S 11TH ST, SUITE 701, PHILADELPHIA, PA 19107-4824
(215) 955-7000
(215) 503-7007
Mailing address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-7000
(215) 503-7007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
CI-0010214
DE
207R00000X
Internal Medicine Physician
Primary
MD425173
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101504120
—
PA
Enumeration date
05/17/2006
Last updated
01/07/2016
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