Most Relevant Information
Provider Data
| NPI Number: | 1003393190 |
| Provider Name: | DEVYN PORATH |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 5315094078 |
Most Important Dates
| Enumeration Date: | 07/23/2018 |
| Last Updated: | 07/23/2018 |
Provider Practice Location
39555 W 10 MILE RD STE 302
NOVI
MI
483752950
Practice Location Phone/Fax
| Phone: | 2484267200 |
| Fax: |
Provider Mailing Location
15739 SCOTT ST
SOUTHGATE
MI
481951323
Provider Mailing Phone/Fax
| Phone: | 7343087224 |
| Fax: |