MEDICARE: TIFFANY DIAS

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	237600000X	Audiologist-Hearing Aid Fitter	02604	MD

General Provider Information

NPI Number	:	1841860913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY DIAS

Provider Business Mailing Address
First Line	:	3010 CRAIN HWY STE 302
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20601-2838
Country	:	US
Telephone Number	:	301-638-3592
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 CRAIN HWY STE 302
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20601-2838
Country	:	US
Telephone Number	:	301-638-3592
Fax Number	:

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

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	06/30/2021

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Directions to “ TIFFANY DIAS ” Practice Location

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