Individual
MIGUEL JOSE DIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 FRANCIS ST, PULMONARY DIVISION BRIGHAM AND WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(857) 307-0310
(617) 582-6011
Mailing address
75 FRANCIS ST, PULMONARY DIVISION BRIGHAM AND WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(857) 307-0310
(617) 582-6011
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
205529
MA
207RP1001X
Pulmonary Disease Physician
Primary
205529
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2617610
—
MA
Enumeration date
09/20/2005
Last updated
06/07/2012
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