Basic Information
| Provider Information | |||||||||
| NPI: | 1427001080 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIAZ-ARIAS | ||||||||
| FirstName: | MICHELE | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 PORTLAND ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652016677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737778818 | ||||||||
| FaxNumber: | 5737778819 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 PORTLAND ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652016677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737778818 | ||||||||
| FaxNumber: | 5737778819 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 06/30/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 36952 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.