Individual
GERARDO DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
808 N 3RD ST, GOSHEN, IN 46528
(574) 534-0088
(574) 971-8434
Mailing address
808 N 3RD ST, GOSHEN, IN 46528-7100
(574) 534-0088
(574) 971-8434
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71006047A
IN
Other
Enumeration date
02/08/2016
Last updated
03/09/2021
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