SearchWisconsin207Q00000X

Angela Divjak, MD

NPI 1639343973 · on the registry since 2008

Practice

Address
100 County Road B
Shawano, WI 54166
Phone
(715) 524-2161
Organisation at this address
Thedacare, Incorporated
Thedacare, Incorporated
Forefront Dermatology, S.C.
Valley Urologic Associates, Sc
Shopko Stores Operating Co., Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
100

Registry record

Primary taxonomy
207Q00000X
207Q00000X
Also registered as
207Q00000X
Licence states on file
WI, MO
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2012-07-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin