| Kenneth C Diamond Md Pc | |
|
703 Quincy Street Suite 1 Rapid City SD 57701-3669 | |
| (605) 716-6656 | |
| (605) 716-6623 |
| Full Name | Kenneth C Diamond Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 703 Quincy Street, Rapid City, South Dakota |
| Authorized Official Name and Position | Kenneth C Diamond (PRESIDENT) |
| Authorized Official Contact | 6057166656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth C Diamond Md Pc 703 Quincy Street Suite 1 Rapid City SD 57701-3669 Ph: (605) 716-6656 | Kenneth C Diamond Md Pc 703 Quincy Street Suite 1 Rapid City SD 57701-3669 Ph: (605) 716-6656 |
| NPI Number | 1902084619 |
|---|---|
| Provider Enumeration Date | 02/05/2008 |
| Last Update Date | 04/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902084619 | NPI | - | NPPES |
| 4995367 | Other | SD | WELLMARK |
| 5602395 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4008 (South Dakota) | Primary |
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