Healthcare Provider Details

I. General information

NPI: 1891703005
Provider Name (Legal Business Name): SINDHU M. DEVANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CENTRACARE DR #2500 CENTRACARE CLINIC- HEALTH PLAZA SPECIALTIES/ENDOCRINOLO
ST CLOUD MN
56303
US

IV. Provider business mailing address

1900 CENTRACARE DR #2500 CENTRACARE CLINIC- HEALTH PLAZA SPECIALTIES/ENDOCRINOLO
ST CLOUD MN
56303
US

V. Phone/Fax

Practice location:
  • Phone: 320-229-5000
  • Fax:
Mailing address:
  • Phone: 320-229-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number105168-TEMP
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number47195
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: