Individual
TIMOTHY D DIVENS
Active
Individual
TIMOTHY D DIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01050545A
IN
2085R0202X
Diagnostic Radiology Physician
1050545
IN
2085R0204X
Vascular & Interventional Radiology Physician
01050545A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204809
ANTHEM
IN
05
—
20025310A
—
IN
01
—
300124562
RAILROAD MEDICARE
IN
01
—
300138597
RAILROAD MEDICARE
—
01
—
P000233634
RAILROAD MEDICARE
—
01
—
P00023582
RAILROAD MEDICARE
—
01
—
P00023583
RAILROAD MEDICARE
—
01
—
P00023584
RAILROAD MEDICARE
—
01
—
P00023585
RAILROAD MEDICARE
—
01
—
P00023634
RAILROAD MEDICARE
—
01
—
P00024059
RAILROAD MEDICARE
—
01
—
P00024079
RAILROAD MEDICARE
—
01
—
P00024122
RAILROAD MEDICARE
—
01
—
P00024260
RAILROAD MEDICARE
—
01
—
P00024419
RAILROAD MEDICARE
—
01
—
P00024421
RAILROAD MEDICARE
—
01
—
P00346514
RAILROAD MEDICARE
—
Enumeration date
09/01/2005
Last updated
12/24/2020
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