Provider Demographics
NPI:1881160687
Name:DIAZ, CARLOS M (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:M
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6336 PICCADILLY SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5143
Mailing Address - Country:US
Mailing Address - Phone:251-999-5433
Mailing Address - Fax:251-471-7875
Practice Address - Street 1:6336 PICCADILLY SQUARE DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5143
Practice Address - Country:US
Practice Address - Phone:251-999-5433
Practice Address - Fax:251-255-8474
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.433502084P0804X, 2084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry