Individual provider · Type 1 NPI

George Joseph Devita, PA-C

Medical Physician Assistant · Fort Drum, NY

NPI number 1104803964 Active

Practice location

11050 Mount Belvedere Blvd, Usa Meddac Attn: Credentials
Fort Drum, NY 13602-5438

Fax (315) 772-9498

Mailing address

27082 Waddingham Rd
Evans Mills, NY 13637-3277

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1104803964

George Joseph Devita, PA-C's National Provider Identifier is 1104803964, issued on Dec 22, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fort Drum, NY. The record was last updated on Jul 13, 2026.