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Contact Information

AMANDA DIAMOND
700 1ST AVE S
FARGO, ND58103-1802
 Phone: 701-234-4036
 Fax: 701-234-4160
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for AMANDA DIAMOND · (Female)

NPI Number 1093932212
Status Active
Credentials
Entity Individual
Enumeration date 04/19/2007
Last updated 01/18/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • ND License # 10863
  • RI License # LP00224
  • MN Medicaid 1093932212
  • ND Medicaid 14766
Hospital affiliation(s)
  • LAKE REGION HEALTHCARE CORPORATION - (Acute Care)
    712 SOUTH CASCADE
    FERGUS FALLS, MN 56537
  • MAHNOMEN HEALTH CENTER - (Critical Access)
    414 W JEFFERSON PO BOX 396
    MAHNOMEN, MN 56557
  • SANFORD BEMIDJI MEDICAL CENTER - (Acute Care)
    1300 ANNE ST NW
    BEMIDJI, MN 56601
  • SANFORD MEDICAL CENTER FARGO - (Acute Care)
    801 BROADWAY NORTH
    FARGO, ND 58122
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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