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Individual

KATHRYN E DIETZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
20 PIDGEON HILL DR STE 208, STERLING, VA 20165-6134
(703) 539-6059
Mailing address
2418 W INDIAN TRL STE F, AURORA, IL 60506-1590
(630) 907-0578

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101053428
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4704623
MI
Enumeration date
10/11/2006
Last updated
03/19/2019
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