Provider Demographics
NPI:1154527364
Name:DEVADOSS, HEMALATA J (MD)
Entity type:Individual
Prefix:DR
First Name:HEMALATA
Middle Name:J
Last Name:DEVADOSS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1014 PLEASANT VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2602
Mailing Address - Country:US
Mailing Address - Phone:410-747-8361
Mailing Address - Fax:410-402-7785
Practice Address - Street 1:SPRING GROVE HOSPITAL
Practice Address - Street 2:55 WADE AVE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-4663
Practice Address - Country:US
Practice Address - Phone:410-402-6000
Practice Address - Fax:410-402-7785
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00201462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0020146OtherLICENSE NUMBER
MD911LJ445Medicare ID - Type Unspecified
MDD0020146OtherLICENSE NUMBER