| Angela Dawn Divjak, MD | |
|
100 County Road B, Shawano, WI 54166-7072 | |
| (715) 524-2161 | |
| Not Available |
| Full Name | Angela Dawn Divjak |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 18 Years |
| Location | 100 County Road B, Shawano, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639343973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 57265-20 (Wisconsin) | Primary |
| 207Q00000X | Family Medicine | 2008026576 (Missouri) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Thedacare At Home | Appleton, WI | Hospice |
| Thedacare Medical Center - Shawano | Shawano, WI | Hospital |
| Thedacare Regional Med Ctr - Neenah | Neenah, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Thedacare Medical Center - Shawano, Inc. | 5890605836 | 33 |
| Entity Name | Thedacare Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376656959 PECOS PAC ID: 1759294887 Enrollment ID: O20031106000088 |
| Entity Name | Thedacare Medical Center - Shawano, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548260839 PECOS PAC ID: 5890605836 Enrollment ID: O20031117000117 |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Dawn Divjak, MD Po Box 8003, Appleton, WI 54912-8003 Ph: () - | Angela Dawn Divjak, MD 100 County Road B, Shawano, WI 54166-7072 Ph: (715) 524-2161 |
Dr. Mindy Maria Frimodig, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 County Road B, Shawano, WI 54166 Phone: 715-524-2161 Fax: 715-524-8164 | |
Dr. Richard Dennis Sarnwick, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1346 E Green Bay St, Shawano, WI 54166 Phone: 715-526-8800 | |
Gregory Thatcher, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 100 County Road B, Shawano, WI 54166 Phone: 715-524-2161 Fax: 715-524-8164 | |
Dr. John Edward Laabs, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 100 County Road B, Shawano, WI 54166 Phone: 715-524-2161 Fax: 715-524-8164 | |
Tod C Lewis, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1346 E Green Bay St, Shawano, WI 54166 Phone: 715-526-6244 | |
Alisha Frances Fahley, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 County Road B, Shawano, WI 54166 Phone: 715-524-2161 Fax: 715-524-8164 | |
Cornelius W Hyzer Jr., MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 County Road B, Shawano, WI 54166 Phone: 715-524-2161 Fax: 715-526-3461 |