Provider Demographics
NPI:1336589035
Name:DIAMOND, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1301 S CLIFF AVE
Mailing Address - Street 2:PLAZA 2, SUITE 401
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105
Mailing Address - Country:US
Mailing Address - Phone:605-322-7300
Mailing Address - Fax:605-322-7301
Practice Address - Street 1:1301 S CLIFF AVE
Practice Address - Street 2:PLAZA 2, SUITE 401
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-322-7300
Practice Address - Fax:605-322-7301
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD10801208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation