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Individual
DR. DIANE SIMONE MCDERMOTT
Active
Individual
DR. DIANE SIMONE MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD25154
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01041710
AMERIGROUP
—
01
—
205724681
UNITED HEALTHCARE
—
05
—
3094940
—
TN
01
—
3736131
MEDICARE GROUP PRICING NO
—
01
—
4147626
BCBS
—
01
—
6271922
CIGNA
—
01
—
7078597
AETNA
—
01
—
G20365
HEALTHSPRINGS
—
01
—
SSN
TRICARE
—
01
—
TN0102
AMERICHOICE
—
Enumeration date
12/13/2006
Last updated
11/05/2008
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