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Individual

DR. FADI HASAN DIAB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10141 BIG BEND RD STE 206, RIVERVIEW, FL 33578-7422
(813) 397-1274
(813) 605-6003
Mailing address
10141 BIG BEND RD STE 206, RIVERVIEW, FL 33578-7422
(813) 397-1274
(813) 605-6003

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
0101253084
VA
207RG0100X
Gastroenterology Physician
036091094
IL
207RG0100X
Gastroenterology Physician
Primary
ME117374
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024563000
FL
05
1790112191
VA
Enumeration date
09/30/2013
Last updated
03/21/2022
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