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Individual
DR. GUY ANDREW DIETELS
Active
Individual
DR. GUY ANDREW DIETELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
061800456
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009230645
—
VA
01
—
224243
ANTHEM PROVIDER #
VA
01
—
487193
NVA PROVIDER #
VA
01
—
5709659
AETNA PROVIDER #
VA
Enumeration date
05/10/2006
Last updated
07/18/2008
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