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Organization

DIAMOND MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BENERJI GUDAPATI MD (OWNER)
(219) 448-0369
Entity
Organization

Contact information

Practice address
830 PARK EAST BLVD, LAFAYETTE, IN 47905-0778
(219) 448-0369
Mailing address
3679 WAKEFIELD DR, WEST LAFAYETTE, IN 47906-8708
(219) 448-0369

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
10/27/2017
Last updated
02/14/2018
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