Individual
DR. MAXWELL JOHANNES DIDDAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1090 NE GATEWAY CT NE STE 201, CONCORD, NC 28025-2423
(704) 403-7770
(704) 403-7779
Mailing address
1090 NE GATEWAY CT NE STE 201, CONCORD, NC 28025-2423
(704) 403-7770
(704) 403-7779
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
227243
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2021-00610
NC
207RP1001X
Pulmonary Disease Physician
Primary
2021-00610
NC
Other
Enumeration date
05/05/2017
Last updated
07/04/2024
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