Individual
DR. DARRYL D DIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
711 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017
(859) 331-0774
(859) 578-3800
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 331-0774
(859) 578-3800
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01070816A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
36524
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200501320
—
IN
05
—
2528536
—
OH
05
—
50024713
—
KY
05
—
64083116
—
KY
01
—
P00920125
RR MEDICARE
KY
Enumeration date
05/23/2005
Last updated
11/01/2021
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