Organization
DIAMOND DERMATOLOGY, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE ELAINE DIAMOND MD (OWNER)
(313) 608-8458
Entity
Organization
Contact information
Practice address
3206 N MAIN ST, ROYAL OAK, MI 48073-3424
Mailing address
1377 BEECH ST, PLYMOUTH, MI 48170-2005
(313) 608-8458
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710140785
NPI
MI
Enumeration date
07/16/2020
Last updated
07/16/2020
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