Provider Demographics
NPI:1992169171
Name:DIAZ, ALONSO R (M D)
Entity type:Individual
Prefix:
First Name:ALONSO
Middle Name:R
Last Name:DIAZ
Suffix:
Gender:M
Credentials:M D
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1597 WASHINGTON PIKE STE A22
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2878
Mailing Address - Country:US
Mailing Address - Phone:412-489-6919
Mailing Address - Fax:412-489-6279
Practice Address - Street 1:1597 WASHINGTON PIKE STE A22
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2878
Practice Address - Country:US
Practice Address - Phone:412-489-6919
Practice Address - Fax:412-489-6279
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2023-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA1992169171207RN0300X
PAMD473697207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology