Provider Demographics
NPI:1982604393
Name:MCCLAIN, DIANE M (DO)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:M
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1 HOSPITAL DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9350
Mailing Address - Country:US
Mailing Address - Phone:570-522-4110
Mailing Address - Fax:570-768-3911
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9350
Practice Address - Country:US
Practice Address - Phone:570-522-2000
Practice Address - Fax:570-768-3911
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAE53554207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001163172Medicaid
PA581513Medicare PIN
PAE53554Medicare UPIN