Provider Demographics
NPI:1669436549
Name:DIAMOND, HERBERT S (MD)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:S
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 LIBERTY AVE
Mailing Address - Street 2:SHITE GR-30
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-621-3844
Mailing Address - Fax:412-683-8560
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:SHITE GR-30
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-621-3844
Practice Address - Fax:412-683-8560
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 043228 E207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADI002155OtherHIGHMARK
PADI002155OtherPA BLUE CROSS/BLUE SHIELD
002155Medicare ID - Type UnspecifiedMEDICARE
PADI002155OtherHIGHMARK