Individual
KYLE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 GROVE RD FL 1, GREENVILLE, SC 29605-4210
(864) 455-7899
(864) 455-5474
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101024836
MI
207P00000X
Emergency Medicine Physician
Primary
83112
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
831121
—
SC
Enumeration date
03/20/2017
Last updated
07/28/2022
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