Individual
DIANE IRENE EUGENIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101256652
VA
207R00000X
Internal Medicine Physician
30783
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307830
—
SC
Enumeration date
06/05/2008
Last updated
04/15/2020
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