Divito, Anthony R
Divito, Anthony R is an individual health care provider with primary practice located at 1235 E Cherokee St , Springfield MO 65804-2203. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Divito, Anthony R can be contacted via phone (417) 820-9729.Contact Information
Primary practice address
1235 E Cherokee St
Springfield MO 65804-2203
Phone: (417) 820-9729
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 2011003928 | Missouri |
Profile Details
| NPI number | 1336303411 |
|---|---|
| LBN Legal business name | Divito, Anthony R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2008 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336303411 | NPPES |
| Missouri | MEDICAID | PENDING | |
| Missouri | Other | PENDING | |
| Missouri | MEDICAID | PENDING | |
| Missouri | MEDICAID | PENDING |
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