Individual
DR. DIANE LOUISE FABRICIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 LABORATORY RD STE 101, OAK RIDGE, TN 37830-6808
(865) 482-1692
(865) 482-4070
Mailing address
400 LABORATORY RD STE 101, OAK RIDGE, TN 37830-6808
(865) 482-1692
(865) 482-4070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000030687
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3836002
—
TN
Enumeration date
09/24/2006
Last updated
10/09/2024
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