Provider Demographics
NPI:1144496720
Name:KING, DIANE E (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:E
Last Name:KING
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:464 MAPLE AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3543
Mailing Address - Country:US
Mailing Address - Phone:401-247-0006
Mailing Address - Fax:401-247-0001
Practice Address - Street 1:464 MAPLE AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3543
Practice Address - Country:US
Practice Address - Phone:401-247-0006
Practice Address - Fax:401-247-0001
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2011-07-03
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Provider Licenses
StateLicense IDTaxonomies
RIMD076392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI29499-3OtherBLUE CROSS RI
RI403748OtherBLUE CHIP RI
RI269020042Medicare PIN
RI403748OtherBLUE CHIP RI