Provider Demographics
NPI:1043293137
Name:MCDEVITT, ROBERT J JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:MCDEVITT
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:915 W MICHIGAN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2491
Mailing Address - Country:US
Mailing Address - Phone:937-492-2094
Mailing Address - Fax:937-492-1768
Practice Address - Street 1:915 WEST MICHIGAN STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2491
Practice Address - Country:US
Practice Address - Phone:937-492-2094
Practice Address - Fax:937-492-1768
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2020-12-29
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Provider Licenses
StateLicense IDTaxonomies
OH35056542208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH020013520OtherTRAVELERS RAILROAD
OH0704198Medicaid
OH4466412OtherAETNA
OH000000027446OtherANTHEM
OH000000027446OtherANTHEM
OH0704198Medicaid