Individual
MARTIN V DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002307
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0618002307
STATE OF VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
10/03/2013
Last updated
11/23/2014
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