Provider Demographics
NPI:1437021300
Name:DEVER, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:DEVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:DEVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18788 N VALLEY DR APT SUITE
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1761
Mailing Address - Country:US
Mailing Address - Phone:216-633-4898
Mailing Address - Fax:
Practice Address - Street 1:1020 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3428
Practice Address - Country:US
Practice Address - Phone:419-521-6805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant