Individual
IVAN DIAMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
980 JOHNSON FERRY RD NE, SUITE 620, ATLANTA, GA 30342-1626
(404) 255-2057
(404) 256-4238
Mailing address
980 JOHNSON FERRY RD NE, SUITE 620, ATLANTA, GA 30342-1626
(404) 255-2057
(404) 256-4238
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
23040
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168023
BCBS
GA
01
—
4030778
AETNA
GA
Enumeration date
12/14/2006
Last updated
07/08/2007
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