Individual
ANTONIO R DIAZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
174 LMAH CENTER RD, LOGAN, WV 25601-4058
(304) 792-7130
Mailing address
PO BOX 176, LOGAN, WV 25601-0176
(304) 792-7130
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16814
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000706447
BLUE CROSS/BLUE SHIELD
—
05
—
0115148000
—
WV
05
—
0288291
—
OH
01
—
1493983
UMWA
WV
01
—
550751751
BLUE CROSS/BLUE SHIELD
WV
05
—
64940489
—
KY
Enumeration date
07/17/2006
Last updated
08/19/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us