Individual provider · Type 1 NPI
Gustavo Adolfo Diaz, MD
Facial Plastic Surgery Physician · Fairhope, AL
NPI number
1164599825
Active
Practice location
411 N Section St Ste 5
Fairhope, AL 36532-2650
Fax (251) 517-5049
Mailing address
17026 Carlton Way Rd
Huntersville, NC 28078
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Facial Plastic Surgery Physician | 207YS0123X | 25353 (AL) |
| Facial Plastic Surgery Physician | 207YS0123X | ME103280 (FL) |
| Facial Plastic Surgery Physician Primary | 207YS0123X | 02055 (NC) |
Facial Plastic Surgery Physician: An otolaryngologist who specializes in facial plastic surgery.
About NPI 1164599825
Gustavo Adolfo Diaz, MD's National Provider Identifier is 1164599825, issued on Nov 29, 2006. The primary taxonomy on file is Facial Plastic Surgery Physician (207YS0123X), and the practice location is in Fairhope, AL. The record was last updated on Aug 1, 2019.