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Individual

AJIT B DIVGI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3200 PLEASANT VALLEY RD, KRAEMER CANCER CARE CENTER, WEST BEND, WI 53095-9274
(262) 836-7200
(262) 334-8484
Mailing address
3200 PLEASANT VALLEY RD, KRAEMER CANCER CARE CENTER, WEST BEND, WI 53095-9274
(262) 836-7200
(262) 334-8484

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
21657
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568453223
WI
Enumeration date
11/02/2005
Last updated
09/10/2014
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