Provider Demographics
NPI:1376717348
Name:DIEFFENBACH, PAUL BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:BRIAN
Last Name:DIEFFENBACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:15 FRANCIS ST
Mailing Address - Street 2:CENTER FOR CHEST DISEASES
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6105
Mailing Address - Country:US
Mailing Address - Phone:617-732-6770
Mailing Address - Fax:617-582-6102
Practice Address - Street 1:15 FRANCIS ST
Practice Address - Street 2:CENTER FOR CHEST DISEASES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6105
Practice Address - Country:US
Practice Address - Phone:617-732-6770
Practice Address - Fax:617-582-6102
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2013-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA250616207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine