Individual
DAVID J DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-4500
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-4500
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0420011773
VT
207W00000X
Ophthalmology Physician
250434
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016570
—
VT
01
—
P00755070
RAILROAD MEDICARE
VT
Enumeration date
05/10/2007
Last updated
02/16/2014
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