Individual
MR. CLAUDE GREGORY DIETTRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
104 GAIL DR, ROANOKE RAPIDS, NC 27870-9202
(252) 533-0413
Mailing address
104 GAIL DR, ROANOKE RAPIDS, NC 27870-9202
(252) 533-0413
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024164474
VA
367500000X
Certified Registered Nurse Anesthetist
044226
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051649
—
NC
Enumeration date
08/16/2006
Last updated
04/01/2025
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