# DR. DIANE SIMONE MCDERMOTT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104987262
- **Gender:** F
- **Credential:** MEDICAL DOCTOR

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD25154 | TN | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 11/05/2008

## 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 | — |