Provider Demographics
NPI:1285327379
Name:DIAMOND, ROBERT DOUGLAS
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DOUGLAS
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E SHERMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:49444-2203
Mailing Address - Country:US
Mailing Address - Phone:231-739-4359
Mailing Address - Fax:231-733-6151
Practice Address - Street 1:445 E SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:MUSKEGON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:49444-2203
Practice Address - Country:US
Practice Address - Phone:231-739-4359
Practice Address - Fax:231-733-6151
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)