Provider Demographics
NPI:1942365200
Name:DIAS, MICHAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:DIAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:PPQA MEDICARE COMPLIANCE UNIT 6 WEST
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:1447 YORK ROAD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6017
Practice Address - Country:US
Practice Address - Phone:410-339-5685
Practice Address - Fax:410-339-5620
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2021-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD43474207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
S883F650Medicare ID - Type UnspecifiedGROUP # S883
G26388Medicare UPIN
K679F626Medicare ID - Type Unspecified