Individual
KELLY RENEE DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
516 DELAWARE STREET SE, UMPHYSICIANS IMAGING CENTER, MINNEAPOLIS, MN 55455-0341
(612) 624-1500
Mailing address
720 WASHINGTON AVE SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55414
(612) 884-0649
(612) 676-8992
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
19422
MN
2085R0202X
Diagnostic Radiology Physician
Primary
53312
MN
Other
Enumeration date
02/12/2007
Last updated
03/26/2013
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