Individual
PAMELA M DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1577 CONGRESS ST, PORTLAND, ME 04102
(207) 662-1622
(207) 774-1814
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD14921
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30207724
—
NH
05
—
325040099
—
ME
Enumeration date
09/06/2006
Last updated
11/22/2013
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