Provider Demographics
NPI:1306894910
Name:DEVINE, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:DEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:320 WINDING RIVER LN
Mailing Address - Street 2:STE 303
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3569
Mailing Address - Country:US
Mailing Address - Phone:434-984-4263
Mailing Address - Fax:434-981-6600
Practice Address - Street 1:320 WINDING RIVER LN
Practice Address - Street 2:STE 303
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3569
Practice Address - Country:US
Practice Address - Phone:434-984-4263
Practice Address - Fax:434-981-6600
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2011-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101226895207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V603C32Medicare ID - Type Unspecified
VAG99954Medicare UPIN