Individual
DR. JOSEPH A. DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 BREWSTER ST, DEPARTMENT OF INTERNAL MEDICINE, PAWTUCKET, RI 02860-4400
(401) 729-3100
(401) 729-2054
Mailing address
111 BREWSTER ST, DEPARTMENT OF INTERNAL MEDICINE, PAWTUCKET, RI 02860-4400
(401) 729-3100
(401) 729-2054
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD10665
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007060965
MEDICARE PTAN
RI
05
—
9023606
—
RI
Enumeration date
11/23/2005
Last updated
04/09/2021
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