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NPI Code Detail

MEDICARE: DIAMOND EMERGENCY PHYSICIANS

MEDICARE: DIAMOND EMERGENCY PHYSICIANS
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
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1518139492
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIAMOND EMERGENCY PHYSICIANS
Provider Business Mailing Address
First Line : PO BOX 8178
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-8178
Country : US
Telephone Number : 800-230-5160
Fax Number : 805-564-5087
Provider Business Practice Location Address
First Line : 1409 E LAKE MEAD BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7120
Country : US
Telephone Number : 702-649-7711
Fax Number :
Authorized Official
Title or Position : OWNER
Name : EDWIN HOMANSKY
Credential :
Telephone Number : 800-355-0808
Provider Enumeration Date : 03/31/2008
Last Update Date : 04/20/2008

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Directions to “DIAMOND EMERGENCY PHYSICIANS ” Practice Location

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