Individual
DAVID RAY DIAZ
Active
Individual
DAVID RAY DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
01034550A
IN
2084P0800X
Psychiatry Physician
Primary
01034550A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100126480
—
IN
01
—
264430910
MEDICARE PTAN
IN
01
—
CJ7541
MEDICARE RR GROUP#
IN
01
—
P02556180
RAILROAD PTAN
IN
Enumeration date
08/15/2005
Last updated
04/24/2024
Update your record
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