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Individual

DR. ANNE C DIBALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
71 S FLANNAGAN AVENUE, LEBANON, VA 24266
(276) 883-8042
(276) 883-8044
Mailing address
71 S FLANNAGAN AVENUE, LEBANON, VA 24266
(276) 883-8042
(276) 883-8044

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101047498
VA
2084P0800X
Psychiatry Physician
13214
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
132145
SC
05
1487614301
VA
05
327877
SC
05
405127
SC
01
534147000
MAGELLAN
VA
01
P01414635
RAILROAD MEDICARE
VA
Enumeration date
03/24/2006
Last updated
02/07/2017
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