Individual
AMY LOUISE DIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14655 GALAXIE AVE, APPLE VALLEY, MN 55124-8575
(952) 432-6161
(952) 432-7019
Mailing address
14655 GALAXIE AVE, APPLE VALLEY, MN 55124-8575
(952) 432-6161
(952) 432-7019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38888
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161325100
—
MN
Enumeration date
06/04/2006
Last updated
04/11/2012
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