Individual
SUMAC DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7107 JAHNKE RD, RICHMOND, VA 23225
(804) 320-4967
(804) 320-7130
Mailing address
7107 JAHNKE RD, RICHMOND, VA 23225
(804) 320-4967
(804) 320-7130
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101230549
VA
207Q00000X
Family Medicine Physician
0101230549
VA
207V00000X
Obstetrics & Gynecology Physician
0101230549
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010082595
—
VA
Enumeration date
04/26/2006
Last updated
06/01/2010
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