Provider Demographics
NPI:1699726471
Name:MULLINS, DIANE LOUISE (MD)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:LOUISE
Last Name:MULLINS
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 1:10 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2493
Mailing Address - Country:US
Mailing Address - Phone:828-253-0762
Mailing Address - Fax:828-254-4892
Practice Address - Street 1:509 BILTMORE AVE
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-253-0763
Practice Address - Fax:828-254-4892
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800644207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC220029829OtherRAILROAD MEDICARE
NC891136MMedicaid
NC220029829OtherRAILROAD MEDICARE
F69012Medicare UPIN