Provider Demographics
NPI:1518934223
Name:LANDAUER, DIANE HELEN (MD)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:HELEN
Last Name:LANDAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:42 LAMBERT ST
Mailing Address - Street 2:STE 111
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2421
Mailing Address - Country:US
Mailing Address - Phone:540-932-4629
Mailing Address - Fax:540-932-4616
Practice Address - Street 1:1 GREEN HILL DR
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:VA
Practice Address - Zip Code:24482-2654
Practice Address - Country:US
Practice Address - Phone:540-248-4487
Practice Address - Fax:540-248-5312
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2021-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101051652207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010061571Medicaid
VA010061571Medicaid
VAF32132Medicare UPIN
VAGC1100Medicare PIN