Individual
DR. MARTIN FREDERIK DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
1048 HARVIN WAY, ROCKLEDGE, FL 32955-3229
(321) 636-2111
(321) 636-7180
Mailing address
1048 HARVIN WAY, ROCKLEDGE, FL 32955-3229
(321) 636-2111
(321) 636-7180
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME128710
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018189900
—
FL
Enumeration date
05/07/2010
Last updated
01/03/2024
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