Vidita Divan M.D.

NPI 1043625445 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1043625445
Gender Female
Enumeration Date 06/24/2014
Last Updated 06/24/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
1100 W WELLS ST
APT 1507
MILWAUKEE WI, 53233-2332, US
Phone (414) 736-9407
Fax
Business Location
1100 W WELLS ST
APT 1507
MILWAUKEE WI, 53233-2332, US
Phone
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Vidita Divan M.D. NPI is 1043625445, taxonomy code is 390200000X Vidita Divan M.D. physically located at 1100 W Wells St, Milwaukee WI, 53233-2332. NPI Number Vidita Divan M.D. has the Individual type.

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1043625445 NPI number is provided on an as is basis without warranty of any kind. 1043625445 is maintained by the National Plan & Provider Enumeration System. The contents of Vidita Divan M.D. are for informational purposes only.