Provider Demographics
NPI:1336707066
Name:DIAMANT, MICHAEL JASON (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JASON
Last Name:DIAMANT
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3158 PARTHENON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1249
Mailing Address - Country:US
Mailing Address - Phone:615-727-4677
Mailing Address - Fax:
Practice Address - Street 1:VANDERBILT UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:1211 MEDICAL CENTER DR
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232
Practice Address - Country:US
Practice Address - Phone:615-936-1743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2020-01-27
Deactivation Date:2020-01-16
Deactivation Code:
Reactivation Date:2020-01-27
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program