Healthcare Provider Details

I. General information

NPI: 1669436549
Provider Name (Legal Business Name): HERBERT S DIAMOND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE SHITE GR-30
PITTSBURGH PA
15224-2156
US

IV. Provider business mailing address

4815 LIBERTY AVE SHITE GR-30
PITTSBURGH PA
15224-2156
US

V. Phone/Fax

Practice location:
  • Phone: 412-621-3844
  • Fax: 412-683-8560
Mailing address:
  • Phone: 412-621-3844
  • Fax: 412-683-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD 043228 E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: