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Individual

MICHAEL DOMINICK DIODATO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 W THOMAS RD STE 500, PHOENIX, AZ 85013-4220
(602) 406-4000
(602) 406-6498
Mailing address
500 W THOMAS RD STE 500, PHOENIX, AZ 85013-4220
(602) 406-4000
(602) 406-6498

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036124370
IL
208600000X
Surgery Physician
051916
CT
2086S0102X
Surgical Critical Care Physician
051916
CT
2086S0102X
Surgical Critical Care Physician
Primary
55156
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001519164
CT
Enumeration date
10/22/2008
Last updated
11/29/2018
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