Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ninah Divine, MD

Individual provider Family Medicine Physician · NPI 1174104590

Ninah Divine, MD is a Family Practice in Milwaukee, Wisconsin. Graduated from University of Wisconsin School of Medicine in 2021, 5 years ago. Practices with Gerald L Ignace Indian Health Center Inc, a 14-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Trained at
University of Wisconsin School of Medicine
Licensed in
WI
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

930 W Historic Mitchell St
Milwaukee, WI 53204-3533
Phone: (414) 383-9526
Fax: (414) 649-2711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 84297-20 (WI)

Record details

NPI number1174104590
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 16, 2021
Last updated in NPPESJuly 21, 2025
Certification dateJuly 21, 2025
Mailing address930 W Historic Mitchell St, Milwaukee, WI 53204-3533

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Gerald L Ignace Indian Health Center Inc — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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