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

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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