Provider Demographics
NPI:1043323033
Name:DIAMOND, STEVEN E (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:900 FOULK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3155
Mailing Address - Country:US
Mailing Address - Phone:302-655-8868
Mailing Address - Fax:302-655-3744
Practice Address - Street 1:900 FOULK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3155
Practice Address - Country:US
Practice Address - Phone:302-655-8868
Practice Address - Fax:302-655-3744
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2012-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC2-0002978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE080120995OtherRAILROAD MEDICARE INDIV
DE080120995OtherRAILROAD MEDICARE INDIV
C48787Medicare UPIN