Individual
DR. DIANA J ANTONACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
27355
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11625
BCBS NC
NC
01
—
260032395
RAILROAD MEDICARE
NC
05
—
8911625
—
NC
Enumeration date
06/21/2005
Last updated
10/26/2011
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