Provider Demographics
NPI:1104288604
Name:COLE, DEVON JACOB (MD)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:JACOB
Last Name:COLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:WAKE FOREST BAPTIST MEDICAL CTR
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-8048
Mailing Address - Fax:336-716-1278
Practice Address - Street 1:PO BOX 2959
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28802-2959
Practice Address - Country:US
Practice Address - Phone:828-693-0258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2021-001502085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology