Provider Demographics
NPI:1487879540
Name:DIEHL, JAMES BOYD (CRNA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BOYD
Last Name:DIEHL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11507 WEST WILSON ROAD NE
Mailing Address - Street 2:
Mailing Address - City:FLINTSTONE
Mailing Address - State:MD
Mailing Address - Zip Code:21530
Mailing Address - Country:US
Mailing Address - Phone:301-777-3531
Mailing Address - Fax:
Practice Address - Street 1:CUMBERLAND ANESTHESIA AND PAIN MANAGMENT
Practice Address - Street 2:600 MEMORIAL AVE.
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:301-723-4965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR130257367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered