Pamila Diwan, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301039114 Issued in MI

Practice address

30555 Southfield Rd
Ste 180
Southfield, MI 48076-1221

Phone

(248) 644-8220

Fax

(248) 644-7338

NPI assigned

Nov 29, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pamila Diwan, MD

  • Obstetrics & Gynecology Physician
  • Southfield, MI
  • NPI 1760009070
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1831172303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30555 SOUTHFIELD RD",
            "address_2": "STE 180",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761221",
            "telephone_number": "248-644-8220",
            "fax_number": "248-644-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30555 SOUTHFIELD RD",
            "address_2": "STE 180",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761221",
            "telephone_number": "248-644-8220",
            "fax_number": "248-644-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIWAN",
        "first_name": "PAMILA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301039114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1565615",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Divine Home & Health Support LLC
• Divine Home Care of Michigan
• Divine Homecare Agency LLC
• Divine Mercy Transportation
• Divine Transit LLC
• Dixon Family Dental
• Anthony Dixon-Lobert
• Carol Dixon, MSW/CSW
• Dante Demitrius Dixson, PHD
• DMC Regional Rehabilitation Center Co

• Obstetrics & Gynecology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.