Provider Demographics
NPI:1093754525
Name:MCQUEEN, DIANNE FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANNE
Middle Name:FRANCES
Last Name:MCQUEEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:284 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1831
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:
Practice Address - Street 1:1000 N 1ST ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2833
Practice Address - Country:US
Practice Address - Phone:704-983-2117
Practice Address - Fax:704-983-2636
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC310982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8952125Medicaid
NC2245687FMedicare ID - Type Unspecified
NC8952125Medicaid