Individual
DR. JASON EDWARD DEVENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
431 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2374
(919) 552-2292
(919) 557-7668
Mailing address
431 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2374
(919) 552-2292
(919) 557-7668
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9901396
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89128MR
—
NC
01
—
9901396
LICENSE
NC
Enumeration date
09/14/2005
Last updated
03/25/2010
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