Individual
DANIEL DICKRIEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
20000 HARVARD AVE, WARRENSVILLE HEIGHTS, OH 44122-6805
(216) 491-6000
Mailing address
129 E OAKMONT WAY, NORTHFIELD, OH 44067-2796
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34004386
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0739982
—
OH
01
—
942460636464
CARESOURCE
OH
01
—
P00319998
MEDICARE TRAVELERS RR-GA
OH
Enumeration date
06/01/2006
Last updated
07/08/2007
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