Provider Demographics
NPI:1932100534
Name:DIAMOND, SHERRI LEE (MD)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:LEE
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 E MCCAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2902
Mailing Address - Country:US
Mailing Address - Phone:501-945-8080
Mailing Address - Fax:501-945-5040
Practice Address - Street 1:4509 E MCCAIN BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2902
Practice Address - Country:US
Practice Address - Phone:501-945-8080
Practice Address - Fax:501-945-5040
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-3645207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5M577Medicare PIN
ARH87064Medicare UPIN