Individual
ANTONIO R DIAZ JR.
Active
Individual
ANTONIO R DIAZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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