Healthcare Provider Details

I. General information

NPI: 1144231523
Provider Name (Legal Business Name): DIANE ELIZABETH ALLIGOOD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANNE ALLIGOOD MD

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 W ARLINGTON BLVD
GREENVILLE NC
27834-5704
US

IV. Provider business mailing address

1850 W ARLINGTON BLVD
GREENVILLE NC
27834-5704
US

V. Phone/Fax

Practice location:
  • Phone: 252-752-6101
  • Fax: 252-752-6600
Mailing address:
  • Phone: 252-413-6202
  • Fax: 252-758-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200201573
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: