Healthcare Provider Details

I. General information

NPI: 1316851538
Provider Name (Legal Business Name): MICHAEL JOSEPH DIAMOND PHLEBOTOMIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 ORCHARD RUN RD
DAYTON OH
45449-2831
US

IV. Provider business mailing address

2775 ORCHARD RUN RD
DAYTON OH
45449-2831
US

V. Phone/Fax

Practice location:
  • Phone: 513-630-2752
  • Fax:
Mailing address:
  • Phone: 513-630-2752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberQ4W6Q8T6
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: