Organization
DIVINE DIAGNOSTIC COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUHA ALAKA (OWNER/CEO)
(586) 713-8397
Entity
Organization
Contact information
Practice address
5005 E 14 MILE RD STE 100, STERLING HEIGHTS, MI 48310-6533
(586) 795-3815
(586) 620-6062
Mailing address
5005 E 14 MILE RD STE 100, STERLING HEIGHTS, MI 48310-6533
(586) 795-3815
(586) 620-6062
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E03743
BC
—
05
—
1881901668
—
MI
Enumeration date
09/01/2010
Last updated
08/15/2013
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