# ALAN MERRILL DIETZEK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134160435
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 038845 | CT | — |
| 2086S0129X | Vascular Surgery Physician | 25MA09413600 | NJ | Yes |

## Other

- **Enumeration date:** 06/09/2006
- **Last updated:** 06/16/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 038845 | CONNECTICARE | CT |
| 01 | — | 0V7532 | HEALTH NET | CT |
| 05 | — | 1388455 | — | CT |
| 01 | — | 2372975 | AETNA US HEALTHCARE | CT |
| 01 | — | 810160110 | PHCS | CT |
| 01 | — | 830396 | UNITED HEALTHCARE | CT |
| 01 | — | 8897122 | CIGNA | CT |
| 01 | — | AS1058 | OXFORD | CT |
| 01 | — | P00230453 | RAILROAD MEDICARE | CT |