Provider Demographics
NPI:1083608624
Name:DIAMOND, JOHN D (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3918 BISHOP RD
Mailing Address - Street 2:
Mailing Address - City:BATTLEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27809-9038
Mailing Address - Country:US
Mailing Address - Phone:252-442-1891
Mailing Address - Fax:252-442-7021
Practice Address - Street 1:3918 BISHOP RD
Practice Address - Street 2:
Practice Address - City:BATTLEBORO
Practice Address - State:NC
Practice Address - Zip Code:27809-9038
Practice Address - Country:US
Practice Address - Phone:252-442-1891
Practice Address - Fax:252-442-7021
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9900032207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC80135138OtherRAILROAD MEDICARE
NC8913464OtherCIGNA HEALTHCARE
NC84338OtherMEDCOST
NC1188LOtherBCBSNC
NC891188LMedicaid
NC80135138OtherRAILROAD MEDICARE
NC84338OtherMEDCOST