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Individual
MARYBETH GAIL DIAZ
Active
Individual
MARYBETH GAIL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, DMSC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-15162
NC
363AM0700X
Medical Physician Assistant
0010-15162
NC
Other
Enumeration date
07/06/2024
Last updated
11/01/2025
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