Provider Demographics
NPI:1821092792
Name:DIAMOND, AMY R (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:R
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 E OAKVIEW DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-9729
Mailing Address - Country:US
Mailing Address - Phone:724-627-8582
Mailing Address - Fax:724-627-7756
Practice Address - Street 1:430 E OAKVIEW DR
Practice Address - Street 2:SUITE A
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-9729
Practice Address - Country:US
Practice Address - Phone:724-627-8582
Practice Address - Fax:724-627-7756
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068043L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA331193OtherBCBS
PA250117OtherUPMC
PA0017789730001Medicaid
PA2305348OtherAETNA
PA101021OtherTHREE RIVERS
PAP001714OtherGATEWAY
PAP001714OtherGATEWAY
PA250117OtherUPMC