Provider Demographics
NPI:1912128976
Name:DIAMOND, FRAYDA (RNC, CNM, MPH)
Entity Type:Individual
Prefix:MRS
First Name:FRAYDA
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:RNC, CNM, MPH
Other - Prefix:
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Mailing Address - Street 1:1530 KEY BLVD
Mailing Address - Street 2:APT PH26
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-1531
Mailing Address - Country:US
Mailing Address - Phone:703-528-6679
Mailing Address - Fax:703-528-5536
Practice Address - Street 1:26005 RIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-1892
Practice Address - Country:US
Practice Address - Phone:301-414-2300
Practice Address - Fax:301-414-2306
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA000 1179335207V00000X
MDAC000145367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC147853ZAK4Medicare PIN