Individual
DR. MARCO N. DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
96 CAMPUS DRIVE, SUITE 1, SCARBOROUGH, ME 04074
(207) 885-9905
(207) 396-5600
Mailing address
301C US ROUTE ONE, SCARBOROUGH, ME 04074
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD15173
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037561
ANTHEM
ME
05
—
282820099
—
ME
05
—
30200521
—
NH
Enumeration date
07/06/2006
Last updated
01/26/2015
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