Provider Demographics
NPI:1427318468
Name:CHAWLA, DIVYA SHARMA (DO)
Entity type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:SHARMA
Last Name:CHAWLA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DIVYA
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9200 W WISCONSIN AVENUE
Mailing Address - Street 2:DIVISION OF NEPHROLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-3100
Mailing Address - Fax:414-259-1145
Practice Address - Street 1:9200 W WISCONSIN AVENUE
Practice Address - Street 2:DIVISION OF NEPHROLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-3100
Practice Address - Fax:414-259-1145
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63747207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1427318468Medicaid