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Individual

WOLFGANG F DIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1222 S PATTERSON BLVD, SUITE 400, DAYTON, OH 45402-2684
(937) 496-2600
(937) 496-2610
Mailing address
1222 S PATTERSON BLVD, SUITE 400, DAYTON, OH 45402-2684
(937) 496-2600
(937) 496-2610

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35 05 7188
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000004018
ANTHEM
01
0805083
AETNA
01
1000383
UNITEDHEALTHCARE
05
2000837
OH
01
D57188
HUMANA
Enumeration date
02/03/2006
Last updated
01/15/2013
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