Provider Demographics
NPI:1912267840
Name:MCDEVITT, BRIANNA SHAY (DO)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:SHAY
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:MCDEVITT
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 911057
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1057
Mailing Address - Country:US
Mailing Address - Phone:888-269-7001
Mailing Address - Fax:303-764-6640
Practice Address - Street 1:2312 N NEVADA AVE STE 235
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907
Practice Address - Country:US
Practice Address - Phone:719-571-8840
Practice Address - Fax:719-571-8845
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2228770208600000X
CODR.00607072086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery