Basic Information
Provider Information
NPI: 1598033201
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIAZ
FirstName: FRANCISCO
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 E MEDICAL CENTER DRIVE
Address2: 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
City: ANN ARBOR
State: MI
PostalCode: 481095054
CountryCode: US
TelephoneNumber: 8008627284
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/08/2011
LastUpdateDate: 01/04/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZF0201X4301077331MIY Allopathic & Osteopathic PhysiciansPathologyForensic Pathology

No ID Information.


Home