Individual
DIANE SIONE TANABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
280 SMITH AVE N STE 400, LUFKIN EYE CLINIC, PA, SAINT PAUL, MN 55102-2473
(651) 292-8200
(651) 292-1801
Mailing address
PO BOX 18128, LUFKIN EYE CLINIC, PA, SAINT PAUL, MN 55118-0128
(651) 292-8205
(651) 292-1801
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21440
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180010745
PALMETTO GBA RAILROAD MED
MN
01
—
28943TA
BCBS OF MINNESOTA
MN
05
—
841890000
—
MN
Enumeration date
08/25/2006
Last updated
04/27/2017
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