Individual
PETER S DIAMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2000
(262) 741-2180
Mailing address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2000
(262) 741-2180
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
67017
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060041167
RRMC-LOCALITY 16
IL
05
—
100048791
—
WI
01
—
1316998578
NPI GROUP PRACTICE
IL
01
—
1616378
BCBS
ID
01
—
4064709
AETNA
IL
01
—
L57038
MEDICARE PIN-LOCALITY 16
IL
01
—
L71656
MEDICARE PIN-LOCALITY 15
IL
Enumeration date
05/31/2006
Last updated
04/06/2023
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