Individual
HARRY C DIETZ III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-3071
Mailing address
PO BOX 64316, BALTIMORE, MD 21264-4316
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
D38909
MD
208000000X
Pediatrics Physician
D38909
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
604171000
—
MD
Enumeration date
06/27/2006
Last updated
12/10/2016
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