Provider Demographics
NPI:1942881909
Name:DIEZ, JOHN ROBYN V (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN ROBYN
Middle Name:V
Last Name:DIEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 WOLF ACRES DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-2046
Mailing Address - Country:US
Mailing Address - Phone:301-533-2190
Mailing Address - Fax:
Practice Address - Street 1:69 WOLF ACRES DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-2046
Practice Address - Country:US
Practice Address - Phone:301-533-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0102636207RA0401X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program