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General NPI Number Information
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NPI Number | 1912081019
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Entity Type | Individual
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Provider Name | MARK PHILIP DIAMOND MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9105 FRANKLIN SQUARE DRIVE SUITE 308
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City | BALTIMORE
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State | MD
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Zip | 21237
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Country | US
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Telephone | 410-574-5877
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Fax | 410-574-5879
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Provider Business Mailing Address
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Address Line | 925 DROHOMER PLACE
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City | BALTIMORE
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State | MD
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Zip | 21210
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Country | US
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Telephone | 410-435-2933
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Fax | 410-574-5879
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | D0022200
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License Number State | MD
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