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General NPI Number Information
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NPI Number | 1124168802
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Entity Type | Organization
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Legal Business Name | STEVEN E DIAMOND, DO LLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 900 FOULK RD SUITE 200
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City | WILMINGTON
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State | DE
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Zip | 19803-3155
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Country | US
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Telephone | 302-655-8868
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Fax | 302-655-3744
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Provider Business Mailing Address
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Address Line | 900 FOULK RD SUITE 200
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City | WILMINGTON
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State | DE
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Zip | 19803-3155
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Country | US
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Telephone | 302-655-8868
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Fax | 302-655-3744
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN E DIAMOND
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Credential | D.O.
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Telephone | 302-655-8868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1991829063
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License Number State | DE
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