Individual
DEVINA KOMALAWATI SIREGAR MCCRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
661 E ALTAMONTE DR STE 231, ALTAMONTE SPRINGS, FL 32701-5102
(407) 303-5214
(407) 303-5215
Mailing address
661 E ALTAMONTE DR STE 231, ALTAMONTE SPRINGS, FL 32701-5102
(407) 303-5214
(407) 303-5215
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101260265
VA
208600000X
Surgery Physician
35.126197
OH
208600000X
Surgery Physician
A121268
CA
208600000X
Surgery Physician
Primary
ME107029
FL
Other
Enumeration date
03/06/2012
Last updated
09/01/2020
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