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NPI Code Detail

MEDICARE: DR. DONITA KAY DIAMOND D.O.

MEDICARE:  DR. DONITA KAY DIAMOND  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician5101015451MI

General Provider Information

NPI Number : 1700855715
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONITA KAY DIAMOND D.O.
Provider Business Mailing Address
First Line : 6300 TWENTY-TWO MILE RD
Second Line : SUITE 1
City : SHELBY TOWNSHIP
State : MI
Zip : 48317
Country : US
Telephone Number : 586-739-9090
Fax Number :
Provider Business Practice Location Address
First Line : 6300 TWENTY-TWO MILE RD
Second Line : SUITE 1
City : SHELBY TOWNSHIP
State : MI
Zip : 48317
Country : US
Telephone Number : 586-739-9090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 09/17/2007

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Directions to “ DR. DONITA KAY DIAMOND D.O.” Practice Location

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