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Individual

DR. ESMERALDO DIAZ HERRERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 JV MANGUBAT DR, WAYNESBORO, TN 38485-2440
(931) 722-9999
(931) 722-2049
Mailing address
101 JV MANGUBAT DR, WAYNESBORO, TN 38485-2440
(931) 722-9999
(931) 722-2049

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25806
TN
207R00000X
Internal Medicine Physician
Primary
25806
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3085092
TN
05
3710089
TN
Enumeration date
01/05/2006
Last updated
07/10/2019
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