# DR. BERNARDO FABIAN DIAZ JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1609255447
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 2022030140 | MO | — |
| 208600000X | Surgery Physician | 654947 | PA | — |
| 2086S0102X | Surgical Critical Care Physician | 2022030140 | MO | — |
| 2086S0102X | Surgical Critical Care Physician | D98084 | MD | Yes |
| 2086S0102X | Surgical Critical Care Physician | MD473032 | PA | — |
| 2086S0127X | Trauma Surgery Physician | 2022030140 | MO | — |

## Other

- **Enumeration date:** 05/26/2015
- **Last updated:** 12/05/2023