Provider Demographics
NPI:1285607861
Name:DIAMOND, ERIC N (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:N
Last Name:DIAMOND
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 1:100 BRIGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090
Mailing Address - Country:US
Mailing Address - Phone:781-471-2200
Mailing Address - Fax:
Practice Address - Street 1:100 BRIGHAM WAY
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090
Practice Address - Country:US
Practice Address - Phone:781-471-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54336207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3188507Medicaid
MAJ05866OtherBLUE CROSS
MAPM476OtherHARVARD PILGRIM
MA054336OtherTUFTS
MA054336OtherTUFTS
MAJ05866OtherBLUE CROSS