Individual
MR. ALAN DIVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26378
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401146
MEDICA
MN
05
—
876265100
—
MN
01
—
HP19647
HEALTH PARTNERS
MN
Enumeration date
07/20/2005
Last updated
11/10/2020
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