Provider Demographics
NPI:1740691054
Name:SHANKARANARAYANAN, DIVYA (MD)
Entity type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:
Last Name:SHANKARANARAYANAN
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 1:2150 PENNSYLVANIA AVE NW STE 3-438
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-3201
Mailing Address - Country:US
Mailing Address - Phone:202-741-2282
Mailing Address - Fax:
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW STE 3-438
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3201
Practice Address - Country:US
Practice Address - Phone:202-741-2282
Practice Address - Fax:202-741-2285
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD048609207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology