Individual
DR. GERARD JOHN DIEFES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 CITY LINE AVE, WB 113, WYNNEWOOD, PA 19096-3902
(610) 896-0280
(610) 896-0286
Mailing address
1001 CITY LINE AVE, WB 113, WYNNEWOOD, PA 19096-3902
(610) 896-0280
(610) 896-0286
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD056949L
PA
207RP1001X
Pulmonary Disease Physician
Primary
MD056949L
PA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD056949L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001781333
—
PA
Enumeration date
11/03/2005
Last updated
05/20/2025
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