Individual
MARVIN DIAZ-LACAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 DORCHESTER AVE, DORCHESTER CENTER, MA 02124-5615
(617) 296-4000
(617) 474-3856
Mailing address
2100 DORCHESTER AVE, DORCHESTER CENTER, MA 02124-5615
(617) 506-4901
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
223423
MA
Other
Enumeration date
06/01/2006
Last updated
10/19/2011
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