Lookup NPI Numbers from the NPI Registry
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Point of Service |
305S00000X |
| NPI # | 1881901668 |
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| LBN Legal business name | DIVINE DIAGNOSTIC COMPANY | ||||||||
| Authorized official | SUHA ALAKA - (OWNER/CEO) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 09/01/2010 | ||||||||
| Last updated | 08/15/2013 - About 13 years ago | ||||||||
| Identifiers |
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DIVINE DIAGNOSTIC COMPANY
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| KIMBERLY S JOHNSON, MD 1105 SIXTH STREET 49684 TRAVERSE CITY, MI (GRAND TRAVERSE), MI |
| SARAH L FRACALA 2399 WALTON BVLD ABURN HILLS, MI |
DIVINE DIAGNOSTIC COMPANY