Provider Demographics
NPI:1598753097
Name:DIAMOND, BETH G (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:G
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:71 OLD MILL BOTTOM RD N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-5431
Mailing Address - Country:US
Mailing Address - Phone:410-268-3887
Mailing Address - Fax:410-268-8171
Practice Address - Street 1:71 OLD MILL BOTTOM RD N
Practice Address - Street 2:SUITE 300
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21409-5431
Practice Address - Country:US
Practice Address - Phone:410-268-3887
Practice Address - Fax:410-268-8171
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2015-03-25
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Provider Licenses
StateLicense IDTaxonomies
MDD0053350207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD488701800Medicaid
MD721LMedicare PIN
MDF78831Medicare UPIN