Provider Demographics
NPI:1467451468
Name:DIAZ, DANILO V (MD)
Entity Type:Individual
Prefix:DR
First Name:DANILO
Middle Name:V
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-5130
Mailing Address - Fax:717-637-3443
Practice Address - Street 1:1227 BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-4406
Practice Address - Country:US
Practice Address - Phone:717-812-5130
Practice Address - Fax:717-637-3443
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424306207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012097750001Medicaid
PA1642665OtherHIGHMARK BLUE SHIELD
PA416561OtherUPMC-WMG
PA1541227OtherGATEWAY-WMG
PA30088999OtherAMERIHEALTH MERCY-WMG
MD973499OtherCAREFIRST MD BCBS-WMG
PA50042965OtherCAPITAL BLUE CROSS
PAP00925228Medicare PIN
MD973499OtherCAREFIRST MD BCBS-WMG
H30586Medicare UPIN