Healthcare Provider Details

I. General information

NPI: 1801022595
Provider Name (Legal Business Name): DIANE CARANTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANE GODAR

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MDG/RAF LAKENHEATH UNIT 5115
APO AE
09461
US

IV. Provider business mailing address

48 MDG/RAF LAKENHEATH UNIT 5115
APO AE
09461
US

V. Phone/Fax

Practice location:
  • Phone: 314-226-8760
  • Fax:
Mailing address:
  • Phone: 314-226-8760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD2021-0687
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number0101250390
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101250390
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: