MEDICARE: DR. AMY R DIAMOND MD

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
1	207Q00000X	Family Medicine Physician	MD068043L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	331193	OTHER	PA	BCBS
2	250117	OTHER	PA	UPMC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2305348	OTHER	PA	AETNA
5	101021	OTHER	PA	THREE RIVERS
6	P001714	OTHER	PA	GATEWAY

General Provider Information

NPI Number	:	1821092792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY R DIAMOND MD

Provider Business Mailing Address
First Line	:	430 E OAKVIEW DR
Second Line	:	SUITE A
City	:	WAYNESBURG
State	:	PA
Zip	:	15370-9729
Country	:	US
Telephone Number	:	724-627-8582
Fax Number	:	724-627-7756

Provider Business Practice Location Address
First Line	:	430 E OAKVIEW DR
Second Line	:	SUITE A
City	:	WAYNESBURG
State	:	PA
Zip	:	15370-9729
Country	:	US
Telephone Number	:	724-627-8582
Fax Number	:	724-627-7756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	04/08/2022

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