Healthcare Provider Details

I. General information

NPI: 1528559978
Provider Name (Legal Business Name): DIANA PADGET DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANA F DEANGELIS

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 LAMB CIR STE 201
CHRISTIANSBURG VA
24073-6344
US

IV. Provider business mailing address

213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US

V. Phone/Fax

Practice location:
  • Phone: 540-731-2328
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0102209145
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number5101028176
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102209145
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5151011731
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: