# DIEKMAN DYSAUTONOMIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912738121
- **Authorized official:** DR. SARAH DIEKMAN MD (DIRECTOR)
- **Authorized official phone:** (219) 928-3500

## Contact information

- **Practice address:** 5000 THAYER CTR, OAKLAND, MD 21550-1139
- **Practice address phone:** (219) 928-3500
- **Mailing address:** 1300 PALMYRA LN, BOWIE, MD 20716-1812
- **Mailing address phone:** (219) 928-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/09/2024
- **Last updated:** 08/09/2024