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Individual

ALPHONSUS G. DIAMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
810 S 6TH ST, MONTICELLO, IN 47960-8201
(574) 583-6543
(574) 583-9502
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01068613A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000774056
ANTHEM PROVIDER NUMBER
IN
05
201018230
IN
Enumeration date
06/17/2009
Last updated
02/02/2021
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