Individual
MARIO HUMBERTO DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 MEDICAL PKWY, ACP 4TH FLOOR/SURGICAL HOSPITALIST STE., ANNAPOLIS, MD 21401-3280
(443) 481-1372
(443) 481-1360
Mailing address
PO BOX 64834, BALTIMORE, MD 21264-4834
(443) 481-6573
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D0022049
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112414
KAISER PERMANENTE
—
01
—
145726104
FEDERAL DEPT OF LABOR (WORKMAN'S COMP)
—
01
—
4071161
AETNA PPO
—
01
—
6718667
AETNA HMO
—
01
—
89468104
CAREFIRST
—
01
—
K585007
CAREFIRST
—
Enumeration date
05/31/2006
Last updated
09/17/2010
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