Provider Demographics
NPI:1053149948
Name:WIGGINS, DEVAKI
Entity type:Individual
Prefix:
First Name:DEVAKI
Middle Name:
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SACRAMENTO DR APT 9G
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1644
Mailing Address - Country:US
Mailing Address - Phone:757-951-6653
Mailing Address - Fax:
Practice Address - Street 1:21 SACRAMENTO DR APT 9G
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-1644
Practice Address - Country:US
Practice Address - Phone:757-951-6653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor