Organization
AJIT B DIVGI M.D.,L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJIT B DIVGI M.D. (OWNER)
(262) 781-6521
Entity
Organization
Contact information
Practice address
3267 S 16TH ST, SUITE 208, MILWAUKEE, WI 53215-4500
(262) 781-6521
(262) 781-6563
Mailing address
18980 DANBURY CT, BROOKFIELD, WI 53045-8163
(262) 781-6521
(262) 781-6563
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
21657
WI
207RH0003X
Hematology & Oncology Physician
21657
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568453223
NPI NUMBER -1-INDIVIDUAL
WI
Enumeration date
11/16/2012
Last updated
11/16/2012
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