Individual
LUIS MICHAEL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
970 TOMMY MUNRO DR STE B, BILOXI, MS 39532-2130
(228) 396-2663
(228) 396-2664
Mailing address
970 TOMMY MUNRO DR STE B, BILOXI, MS 39532-2130
(228) 396-2663
(228) 396-2664
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19063
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260367832
TAX ID
MS
Enumeration date
06/21/2007
Last updated
08/20/2012
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