Divya Goutam Vijendra
Internist Medical Oncology Geriatric Medicine
433 W High St
Bryan
, Ohio 43506-1690
Divya Goutam Vijendra
Internist Medical Oncology Geriatric Medicine
433 W High St
Bryan
, Ohio 43506-1690
(419) 636-3100
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About
Features
Specialties
- Internist
- Geriatric Medicine
- Medical Oncology
Languages spoken
- English
Location
First Address
- Divya Goutam Vijendra
- 433 W High St
- Bryan, OH
- Zip : 43506-1690
- Fax : (419) 636-3100
- Phone : (419) 636-1131
Second Address
- Divya Goutam Vijendra
- 433 W High St
- Bryan, OH
- Zip : 43506-1690
- Fax : (419) 636-3100
- Phone : (419) 636-1131
Reviews
FAQs
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Is Divya Goutam Vijendra a sole practitioner?
Is Divya Goutam Vijendra accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 35-084674 | OH |
| N | 111NI0900X | Internist | 35-084674 | OH |
| N | 207RG0300X | Geriatric Medicine | 35084674 | OH |
| Y | 207RX0202X | Medical Oncology | 35084674 | OH |
National Provider Identifier
| NPI | 1164502373 |
|---|---|
| Provider Name | Divya Goutam Vijendra |
| First Address | Bryan, OH 43506-1690 |
| Second Address | Bryan, OH 43506-1690 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/10/2006 |
| Last Update Date | 20/08/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 2491683 | (05) | OH |
| I15874 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.