Provider Demographics
NPI:1669707956
Name:MEEKINS MOORE, DIAHANN M (MD)
Entity type:Individual
Prefix:DR
First Name:DIAHANN
Middle Name:M
Last Name:MEEKINS MOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DIAHANN
Other - Middle Name:
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4828 ASHFORD DUNWOODY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4833
Mailing Address - Country:US
Mailing Address - Phone:707-238-2674
Mailing Address - Fax:678-573-4457
Practice Address - Street 1:4828 ASHFORD DUNWOODY RD STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-4833
Practice Address - Country:US
Practice Address - Phone:707-238-2674
Practice Address - Fax:678-573-4457
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI666032084P0800X
IN01070915A2084P0800X
GA634582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry