Provider Demographics
NPI:1356349179
Name:SNEED, DIANE COPPOCK (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:COPPOCK
Last Name:SNEED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DIANE
Other - Middle Name:L
Other - Last Name:COPPOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1301 S CLIFF AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1019
Mailing Address - Country:US
Mailing Address - Phone:605-322-7200
Mailing Address - Fax:605-322-7222
Practice Address - Street 1:1301 S CLIFF AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1019
Practice Address - Country:US
Practice Address - Phone:605-322-7200
Practice Address - Fax:605-322-7222
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30779207ZP0102X
MN46498207ZP0102X
SD3372207ZP0102X
TXH0264207ZP0102X
NE23178207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN399365500Medicaid
SDS34Medicare PIN
SDS3026Medicare PIN
E78932Medicare UPIN
SD220008592Medicare PIN