Healthcare Provider Details

I. General information

NPI: 1841493400
Provider Name (Legal Business Name): DIANE JANE CAMPBELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANE JANE CAMPBELL MD

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 HEMBY LN
GREENVILLE NC
27834-3775
US

IV. Provider business mailing address

PO BOX 751069
CHARLOTTE NC
28275-1069
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-4500
  • Fax: 252-744-3472
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number12970
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number29235
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: