Individual
DR. MICHAEL J DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14231 SEAWAY RD STE 5003, GULFPORT, MS 39503-4660
(228) 864-4392
(228) 868-7103
Mailing address
PO BOX 1330, GULFPORT, MS 39502-1330
(228) 864-4392
(228) 868-7103
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
13433
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00155062
—
MS
Enumeration date
08/03/2005
Last updated
11/03/2017
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