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Individual

MR. E DEVAULT CLEVENGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
241 GRANT ST, WEST END, NC 27376
(910) 673-3535
Mailing address
3125 POPLARWOOD CT, SUITE 300, RALEIGH, NC 27604-1084
(919) 790-8580
(919) 341-0231

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
185339
MED COST
NC
01
22990
BCBS
NC
05
6002228
NC
Enumeration date
02/26/2007
Last updated
02/18/2011
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