Provider Demographics
NPI:1174562102
Name:MCSHANE, DIANA BORTON (MD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:BORTON
Last Name:MCSHANE
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 1:5324 MCFARLAND RD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6865
Mailing Address - Country:US
Mailing Address - Phone:919-401-7733
Mailing Address - Fax:919-401-7767
Practice Address - Street 1:5324 MCFARLAND RD
Practice Address - Street 2:SUITE 410
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6865
Practice Address - Country:US
Practice Address - Phone:919-401-7733
Practice Address - Fax:919-401-7767
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00498207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology