Individual
AMANDA DIAMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4036
(701) 234-4160
Mailing address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4036
(701) 234-4160
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
10863
ND
2084N0600X
Clinical Neurophysiology Physician
LP00224
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093932212
—
MN
05
—
14766
—
ND
Enumeration date
04/19/2007
Last updated
01/18/2012
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