Provider Demographics
NPI:1447497136
Name:EMES, DIANE E (MD)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:E
Last Name:EMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:814-724-3333
Mailing Address - Fax:814-724-3302
Practice Address - Street 1:1015 GROVE ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2905
Practice Address - Country:US
Practice Address - Phone:814-724-3333
Practice Address - Fax:814-724-3302
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD438892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102494913Medicaid
PAP010714OtherGATEWAY
PA2517200OtherHIGHMARK BLUE SHIELD
PA415290OtherUPMC
PA2517200OtherHIGHMARK BLUE SHIELD