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NPI Code Detail

MEDICARE: DR. ELLIOT DIAMOND DPM

MEDICARE: DR. ELLIOT DIAMOND DPM
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
1213E00000XPodiatristSC002164LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D11537095OTHERB.S.
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831195445
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELLIOT DIAMOND DPM
Provider Business Mailing Address
First Line : 123 CHESTNUT STREET
Second Line : STE 201
City : PHILADELPHIA
State : PA
Zip : 19106-3051
Country : US
Telephone Number : 215-923-2455
Fax Number : 215-923-4535
Provider Business Practice Location Address
First Line : 123 CHESTNUT ST STE 201
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-3051
Country : US
Telephone Number : 215-923-2455
Fax Number : 215-923-4535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 01/08/2009

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