Organization
KENNETH C DIAMOND MD PC
Active
Other names
Diamond Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH C DIAMOND MD (PRESIDENT)
(605) 716-6656
Entity
Organization
Contact information
Practice address
703 QUINCY STREET, SUITE 1, RAPID CITY, SD 57701-3669
(605) 716-6656
(605) 716-6623
Mailing address
703 QUINCY STREET, SUITE 1, RAPID CITY, SD 57701-3669
(605) 716-6656
(605) 716-6623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4008
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4995367
WELLMARK
SD
05
—
5602395
—
SD
Enumeration date
02/05/2008
Last updated
04/13/2011
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