Diaz, Larry Jose

Diaz, Larry Jose is an individual health care provider with primary practice located at 2122 Health Dr Sw , Wyoming MI 49519-9698. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Diaz, Larry Jose can be contacted via phone (616) 252-5950.

Contact Information

Primary practice address
2122 Health Dr Sw Wyoming MI 49519-9698
Phone: (616) 252-5950
Fax: (616) 252-5956
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 203831 Massachusetts
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME93966 Florida
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 4301097454 Michigan

Profile Details

NPI number 1952301038
LBN Legal business name Diaz, Larry Jose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Dec 8th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952301038 NPPES
Michigan Other 4301097454 STATE LICENSE

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