Provider Demographics
NPI:1639322761
Name:DIAMOND CARE INC
Entity Type:Organization
Organization Name:DIAMOND CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GRAHAM
Authorized Official - Last Name:CARLOS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:877-323-4449
Mailing Address - Street 1:8310 ALLISON POINTE BLVD
Mailing Address - Street 2:STE 204-B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1981
Mailing Address - Country:US
Mailing Address - Phone:877-323-4440
Mailing Address - Fax:
Practice Address - Street 1:8310 ALLISON POINTE BLVD
Practice Address - Street 2:STE 204-B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1981
Practice Address - Country:US
Practice Address - Phone:877-323-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062620A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty