Basic Information
| Provider Information | |||||||||
| NPI: | 1013998509 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEVLIN | ||||||||
| FirstName: | RONI | ||||||||
| MiddleName: | KRISTIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1189 | ||||||||
| Address2: | |||||||||
| City: | CORVALLIS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973391189 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER | ||||||||
| Address2: | 7503 SURRATTS RD | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018688000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 11/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 4301072914 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RI0200X | D0088533 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RI0200X | MD201503 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.