Provider Type Icon

JAGANNADHARAO DIVVELA MD NPI 1093790867


NPI Information

NPI: 1093790867
Provider Name: JAGANNADHARAO DIVVELA, MD
Classification: Internal Medicine - 207R00000X
Entity Type: Individual
Address:
8244 METROPOLITAN PKWY
SUITE C
STERLING HEIGHTS, MI
ZIP 48312
Phone: (586) 795-4060
Get Directions

Jagannadharao Divvela, MD is an internal medicine in Sterling Heights, MI. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. Jagannadharao Divvela, MD NPI is 1093790867. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8244 METROPOLITAN PKWY
SUITE C
STERLING HEIGHTS, MI
ZIP 48312-778
Phone: (586) 795-4060
Fax: (586) 795-5596

The enumeration date for this NPI number is 12/14/2005 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine4301039338MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14587910MEDICAIDMICHIGAN
2A76071MEDICARE UPINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.