Diaz, Michael J

Diaz, Michael J is an individual health care provider with primary practice located at 14231 Seaway Rd Ste 5003 , Gulfport MS 39503-4660. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Diaz, Michael J can be contacted via phone (228) 864-4392.

Contact Information

Primary practice address
14231 Seaway Rd Ste 5003 Gulfport MS 39503-4660
Fax: (228) 868-7103
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 13433 Mississippi

Profile Details

NPI number 1780685578
LBN Legal business name Diaz, Michael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Nov 3rd, 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 1780685578 NPPES
Mississippi MEDICAID 00155062

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