Healthcare Provider Details

I. General information

NPI: 1750716890
Provider Name (Legal Business Name): ARIAM SCARLET DIAZ- MATHUSEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARIAM SCARLET DIAZ-VALDEZ MD

II. Dates (important events)

Enumeration Date: 09/09/2013
Last Update Date: 09/28/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 S MEBANE ST
BURLINGTON NC
27215-6235
US

IV. Provider business mailing address

2501 S MEBANE ST
BURLINGTON NC
27215-6235
US

V. Phone/Fax

Practice location:
  • Phone: 336-228-7337
  • Fax: 336-222-0293
Mailing address:
  • Phone: 336-228-7337
  • Fax: 336-222-0293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA934100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2021-01492
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number270653
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: