Organization
RICHARD G. DIETHELM, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD G DIETHELM M.D. (PRESIDENT)
(205) 836-9366
Entity
Organization
Contact information
Practice address
48 MEDICAL PARK DR E STE 351, BIRMINGHAM, AL 35235-3467
(205) 836-9366
(205) 836-9367
Mailing address
48 MEDICAL PARK DR E STE 351, BIRMINGHAM, AL 35235-3467
(205) 836-9366
(205) 836-9367
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
26360
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009910701
—
AL
05
—
529932807
—
AL
01
—
DG1281
RAILROAD MEDICARE
AL
Enumeration date
04/18/2007
Last updated
05/13/2024
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