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Individual

MR. OLIVER B DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
46 GOODWIN ST, BRISTOL, CT 06010-5807
(860) 589-5593
(860) 584-0056
Mailing address
46 GOODWIN ST, BRISTOL, CT 06010-5807
(860) 589-5593

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
016620
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001166206
CT
01
0016620600
BLUE CARE FAMILY
CT
01
010016620CT01
BLUE SHIELD
CT
01
0192997
CIGNA
CT
01
4342196
AETNA
CT
01
500HBX031CT01
BLUE CROSS
CT
01
791603
CONNECTICARE
CT
01
83286
U.S. HEALTHCARE
CT
01
OR1837
HEALTHNET
CT
01
P464314
OXFORD
CT
Enumeration date
08/05/2006
Last updated
06/09/2020
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