Individual
MICHAEL PATRICK DEITRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
Mailing address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0116041343
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
04/02/2025
Last updated
07/03/2025
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