Provider Demographics
NPI:1598757957
Name:LITWIN, DIANNE K (MD)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:K
Last Name:LITWIN
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 1:2300 CHAMBER CENTER DR
Mailing Address - Street 2:
Mailing Address - City:FT. MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1673
Mailing Address - Country:US
Mailing Address - Phone:859-757-2927
Mailing Address - Fax:859-341-0203
Practice Address - Street 1:651 CENTRE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-5423
Practice Address - Country:US
Practice Address - Phone:859-757-2927
Practice Address - Fax:859-341-0203
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.064219207RC0200X, 207RP1001X
KY32227207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0651601OtherAETNA
OH0904141Medicaid
000000044590OtherANTHEM
1098077OtherPASSPORT
021036000OtherFEDERAL BLACK LUNG
4800056OtherUNITED HEALTHCARE
KY64322274Medicaid
KY0399009Medicare PIN
000000044590OtherANTHEM
KY64322274Medicaid
KY110134933Medicare PIN
021036000OtherFEDERAL BLACK LUNG
L02623Medicare UPIN
1098077OtherPASSPORT
KYP400039942Medicare PIN
KY3400172Medicare PIN
KY3313225Medicare PIN