MEDICARE: DIANE B RICE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	0101035104	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801897509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE B RICE MD

Provider Business Mailing Address
First Line	:	PO BOX 221322
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20153-1322
Country	:	US
Telephone Number	:	703-691-2516
Fax Number	:	703-691-3526

Provider Business Practice Location Address
First Line	:	3300 GALLOWS RD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041
Country	:	US
Telephone Number	:	703-776-3001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/30/2008

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