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DIVINE MEDICAL SERVICES NPI 1629843016


NPI Information

NPI: 1629843016
Provider Name: DIVINE MEDICAL SERVICES
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
700 S SYCAMORE ST STE 15
PETERSBURG, VA
ZIP 23803
Phone: (804) 481-1159
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DIVINE MEDICAL SERVICES is a clinic center in Petersburg, VA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DIVINE MEDICAL SERVICES NPI is 1629843016. The provider is registered as an organization entity type.

The provider's business location address is:

700 S SYCAMORE ST STE 15
PETERSBURG, VA
ZIP 23803-804
Phone: (804) 481-1159
Fax: (804) 203-1919

The provider's authorized official is Chinelo J Okonkwo .
The authorized official title is Independent Practitiner Pa-c and has the following contact phone number (410) 905-5640.

The enumeration date for this NPI number is 11/16/2023 and was last updated on 11/16/2023.


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
1261Q00000XClinic/CenterYes

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.