Provider Demographics
NPI:1245278159
Name:WEEMS, DIANE Z (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:Z
Last Name:WEEMS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:150 SCRANTON CONNECTOR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-0540
Mailing Address - Country:US
Mailing Address - Phone:912-356-2115
Mailing Address - Fax:912-356-2868
Practice Address - Street 1:1395 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3901
Practice Address - Country:US
Practice Address - Phone:912-262-2347
Practice Address - Fax:912-262-3036
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-02-03
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Provider Licenses
StateLicense IDTaxonomies
GA291202080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000471622AMedicaid
GA000471622AMedicaid
GA37BBCKLMedicare PIN