DIVYA GOPALAN VENKAT (NPI# 1356653489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356653489 |
| Entity Type | Individual |
| Full Name | DIVYA GOPALAN VENKAT |
| Other Name | DIVYA VEDA GOPALAN |
| Credential | M.D. |
| Practice Address |
4646 John R St Detroit MI 48201 |
| Mailing Address |
4646 John R St Detroit MI 48201-1916 |
| Practice Telephone | 3135761000 |
| Mailing Telephone | 3135761000 |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2019-05-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
4301109156 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
4301109156 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4646 John R St, Detroit, MI 48201 | 3135761000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750944831 | Divya Venkat | Student in an Organized Health Care Education/Training Program | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2019-04-15 |
| 1174979074 | Divya Venkat | Internal Medicine | 1307 Federal St Ste B300, Pittsburgh, PA 15212-4775 | 2016-05-10 |
| Street Address |
4646 JOHN R ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356344121 | Christopher Emil Hermann | Nurse Practitioner | 4646 John R St, Detroit, MI 48201-1916 | 2005-05-24 |
| 1881293892 | Derrick Williams | Registered Nurse | 4646 John R St, Detroit, MI 48201-1916 | 2020-10-21 |
| 1598371544 | Sonia Govil | Dietitian, Registered | 4646 John R St, Detroit, MI 48201-1916 | 2020-09-16 |
| 1740893569 | Nicholas Edward Peters | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-31 |
| 1710597455 | Amber Michelle Young | Social Worker | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-07 |
| 1104434471 | Zeinab H Moussa | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-22 |
| 1235747346 | Samantha Beth Lewis | Psychologist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-15 |
| 1477171189 | Rima Mohammad Fardos | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-09 |
| 1992323869 | Sarah F Waqhar | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-08 |
| 1619594181 | Mellisa Ann Boyle | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629408315 | Pulmonary & Critical Care One PC | Internal Medicine | 4160 John R St Ste 1011, Harper Professional Building, Detroit, MI 48201-2017 | 2013-11-18 |
| 1902988942 | Anjali Kumar | Internal Medicine | 4160 John R Suite 521, Detroit, MI 48201 | 2006-10-19 |
| 1629077342 | Kevin Carr Kyle | Internal Medicine | 15101 W Mcnichols Rd, Detroit, MI 48235-3716 | 2005-07-14 |
| 1346669355 | Wing Tai Kong | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2014-04-08 |
| 1295099893 | Khaled Alshabani | Internal Medicine | 4201 Saint Antoine St Ste 5a, Detroit, MI 48201-2153 | 2012-06-27 |
| 1841566072 | Kamelia Albujoq | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202 | 2012-04-02 |
| 1487920740 | Abdul Kareem Uduman | Internal Medicine | 2799 W Grand Blvd, Henry Ford Hospital, Detroit, MI 48202-2608 | 2012-03-30 |
| 1942598784 | Mohammed Helmy Mahmoud | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2011-07-14 |
| 1619145315 | Donald G Dimcheff | Internal Medicine | 600 E Lafayette Blvd, Detroit, MI 48226-2927 | 2008-02-15 |
| 1710197835 | Javier Ivan Diaz-mendoza | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2007-05-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.