Provider Demographics
NPI:1962440883
Name:WESTERFIELD, DIANA L (DO)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:L
Last Name:WESTERFIELD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DIANA
Other - Middle Name:L
Other - Last Name:COOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:10 HOSPITAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1659
Mailing Address - Country:US
Mailing Address - Phone:636-916-7272
Mailing Address - Fax:
Practice Address - Street 1:10 HOSPITAL DR STE 100
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1659
Practice Address - Country:US
Practice Address - Phone:636-916-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO118402207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO243969409Medicaid
G91024Medicare UPIN
007013022Medicare ID - Type UnspecifiedFARMINGTON NUMBER
MO243969409Medicaid