Provider Demographics
NPI:1386709624
Name:DEVLIN & HUBERTY PS
Entity type:Organization
Organization Name:DEVLIN & HUBERTY PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MINUDRI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:509-332-7511
Mailing Address - Street 1:623 SOUTH MAIN ST #5
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-2983
Mailing Address - Country:US
Mailing Address - Phone:208-883-0133
Mailing Address - Fax:208-882-8319
Practice Address - Street 1:1205 SE PROFESSIONAL MALL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5423
Practice Address - Country:US
Practice Address - Phone:509-332-7511
Practice Address - Fax:509-334-4712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD40218207VC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VC0200XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyCritical Care MedicineGroup - Multi-Specialty