Provider Demographics
NPI:1124072335
Name:DIAZ-ARIAS, ALBERTO A (MD)
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:A
Last Name:DIAZ-ARIAS
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 1:300 PORTLAND ST STE 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7390
Mailing Address - Country:US
Mailing Address - Phone:573-886-4600
Mailing Address - Fax:573-886-4695
Practice Address - Street 1:300 PORTLAND ST STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7390
Practice Address - Country:US
Practice Address - Phone:573-886-4600
Practice Address - Fax:573-886-4695
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36752207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203171103Medicaid
MO533976OtherIOWA MEDICAID
MO1104040OtherUNITED HEALTHCARE
MO126603OtherHEALTHLINK
MO127403OtherBLUE SHIELD/BLUE CHOICE
MO138623001OtherARKANSAS MEDICAID
MO2086329201OtherKANSAS MEDICAID
MO967005236Medicare PIN
MO1104040OtherUNITED HEALTHCARE
MO533976OtherIOWA MEDICAID
F05440Medicare UPIN
MO220011974Medicare PIN