Individual
DR. DIVJOT KAUR SOOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1215 BROADWAY, RAYNHAM, MA 02767-1942
(508) 894-0400
(508) 894-0412
Mailing address
1215 BROADWAY, RAYNHAM, MA 02767-1942
(508) 894-0400
(508) 894-0412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD13401
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001698302
MEDICARE PTAN
RI
05
—
110085687A
—
MA
01
—
1698301
MEDICARE PTAN
MA
05
—
DS81690
—
RI
Enumeration date
07/05/2007
Last updated
01/12/2024
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