Individual
JERAD DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9002 N MERIDIAN STREET, SUITE 100, INDIANAPOLIS, IN 46260-2301
(317) 844-5530
Mailing address
9002 N MERIDIAN STREET, SUITE 100, INDIANAPOLIS, IN 46260-2296
(317) 844-5530
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004900A
IN
Other
Enumeration date
06/22/2023
Last updated
07/16/2025
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