Healthcare Provider Details

I. General information

NPI: 1427497908
Provider Name (Legal Business Name): DR. SARAH JEAN DIEKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 THAYER CTR STE C
OAKLAND MD
21550-1139
US

IV. Provider business mailing address

2717 SW 98TH DR
GAINESVILLE FL
32608-8679
US

V. Phone/Fax

Practice location:
  • Phone: 833-768-7633
  • Fax: 949-437-2692
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberD0093111
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: