Individual
CHARLES DIETL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2ND AMBULATORY CARE CTR, 2211 LOMAS BLVD. NE, ALBUQUERQUE, NM 87131-0001
(505) 272-6901
(505) 272-6909
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
99-188
NM
Other
Enumeration date
07/30/2006
Last updated
05/18/2012
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