Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 01062306A | IN |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 01062306A | IN |
N | 207VG0400X | Gynecologist | 43070 | KY |
NPI | 1760680938 |
---|---|
Provider Name | Dr. Sara I. Diaz Valentin |
First Address | Richmond, IN 47374-1157 |
Second Address | Richmond, IN 47374-1161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 13/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000001005930 | ANTHEM (01) | IN |
0164408 | (05) | OH |
200961220 | (05) | IN |