Provider Demographics
NPI:1619358876
Name:SHROCK, DEVIN L (MD)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:L
Last Name:SHROCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEVIN
Other - Middle Name:L
Other - Last Name:WADLOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 CAMBRIDGE ST DEPT OF PATHOLOGY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE ST DEPT OF PATHOLOGY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:319-384-8054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-46383207ZP0102X
KS04-44886207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology