Individual
DIANE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3130 N COUNTY ROAD 25A, TROY, OH 45373-1337
(937) 440-4786
Mailing address
PO BOX 750243, DAYTON, OH 45475-0243
(937) 709-5051
(937) 709-5050
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34005328
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2364838
—
OH
01
—
300132256
RAILROAD MEDICARE
—
01
—
CK1297
RAILROAD MEDICARE
OH
Enumeration date
08/01/2006
Last updated
10/27/2023
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