Shakti, Divya

Shakti, Divya is an sole proprietor health care provider with primary practice located at 2500 North State Street , Jackson MS 39216. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Cardiology. Allopathic & Osteopathic Physicians / Pediatric Cardiology is her primary health care specialty. Shakti, Divya can be contacted via phone (601) 984-5250.

Contact Information

Primary practice address
2500 North State Street Jackson MS 39216
Phone: (601) 984-5250
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301090267 Michigan
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 23419 Mississippi

Profile Details

NPI number 1659559300
LBN Legal business name Shakti, Divya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 5th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659559300 NPPES
Michigan Other 998912 DMC EMPLOYEE ID NUMBER
Michigan MEDICAID 05487537 DMC EMPLOYEE ID NUMBER

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