Provider Demographics
NPI:1730227695
Name:DIAMOND, HOWARD IAN (DPM)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:IAN
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SHILOH ST
Mailing Address - Street 2:MAIN OFFICE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1600
Mailing Address - Country:US
Mailing Address - Phone:412-381-3700
Mailing Address - Fax:412-381-5657
Practice Address - Street 1:210 SHILOH ST
Practice Address - Street 2:MAIN OFFICE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15211-1600
Practice Address - Country:US
Practice Address - Phone:412-381-3700
Practice Address - Fax:412-381-5657
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001378-L213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADI139878OtherBLUE SHIELD-KEYSTONE WEST
PA0503897Medicaid
PADI139878Medicare ID - Type UnspecifiedMEDICARE ID
PA0503897Medicaid