Provider Demographics
NPI:1891703005
Name:DEVANI, SINDHU M (MD)
Entity Type:Individual
Prefix:
First Name:SINDHU
Middle Name:M
Last Name:DEVANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRACARE DR #2500
Mailing Address - Street 2:CENTRACARE CLINIC- HEALTH PLAZA SPECIALTIES/ENDOCRINOLO
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303
Mailing Address - Country:US
Mailing Address - Phone:320-229-5000
Mailing Address - Fax:
Practice Address - Street 1:1900 CENTRACARE DR #2500
Practice Address - Street 2:CENTRACARE CLINIC- HEALTH PLAZA SPECIALTIES/ENDOCRINOLO
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303
Practice Address - Country:US
Practice Address - Phone:320-229-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105168-TEMP207RE0101X
WI47195207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34565200Medicaid
WI34565200Medicaid
WI001239270Medicare ID - Type Unspecified