Individual
HECTOR DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
802 NEW HOLLAND AVE, LANCASTER, PA 17602-2163
(717) 560-3782
(717) 560-3787
Mailing address
2414 BULL ST, COLUMBIA, SC 29201-1906
(803) 898-8405
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD039992L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011490660011
—
PA
05
—
0011490660012
—
PA
01
—
111774
VALUE OPTIONS
PA
01
—
153233
HIGHMARK BLUE SHIELD
PA
01
—
4495678
AETNA NON-HMO
PA
01
—
50056764
CAPITAL BLUE CROSS
PA
Enumeration date
04/06/2006
Last updated
05/22/2020
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