Provider Demographics
NPI:1154338879
Name:RAGULA, DIANNA ANDREA (MD)
Entity type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:ANDREA
Last Name:RAGULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 SOUTH SHARE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532
Mailing Address - Country:US
Mailing Address - Phone:228-594-3601
Mailing Address - Fax:228-594-3601
Practice Address - Street 1:150 REYNOIR STREET
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530
Practice Address - Country:US
Practice Address - Phone:228-436-1254
Practice Address - Fax:228-436-1289
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS165772085R0202X
AL000210962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03733573Medicaid
MS300000871Medicare ID - Type Unspecified
MS03733573Medicaid