Provider Demographics
NPI:1891913380
Name:ESPINOSA-HEIDMANN, DIEGO GABRIEL (MD)
Entity type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:GABRIEL
Last Name:ESPINOSA-HEIDMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1499 WALTON WAY
Mailing Address - Street 2:STE 1400
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2650
Mailing Address - Country:US
Mailing Address - Phone:706-828-6410
Mailing Address - Fax:
Practice Address - Street 1:1120 15TH STREET
Practice Address - Street 2:BA 2320
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912
Practice Address - Country:US
Practice Address - Phone:706-721-2020
Practice Address - Fax:706-721-1156
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA062035207WX0107X
SC40446207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist