Individual
MR. STEVEN CHARLES DIAMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2010 OCILLA RD, DOUGLAS, GA 31533-2230
(912) 384-1477
Mailing address
PO BOX 1377, DOUGLAS, GA 31534-1377
(912) 384-1477
(912) 384-1470
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036135
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000669347C
—
GA
01
—
036135
PHYSICIAN LICENSE
GA
01
—
11D0909097
CLIA ID
GA
01
—
341177
WELLCARE
GA
01
—
937878
BC/BS
GA
01
—
DH1281
RAILROAD MEDICARE - GROUP #
GA
01
—
P00473719
RAILROAD MEDICARE - PTAN
GA
Enumeration date
11/01/2006
Last updated
03/07/2023
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