Individual
EMILY DIEDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66103-2937
(913) 636-5226
Mailing address
3940 TERRACE ST, KANSAS CITY, MO 64111-4134
(913) 636-5226
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
AN5240394-5533
IL
207RP1001X
Pulmonary Disease Physician
04-33771
KS
Other
Enumeration date
08/02/2008
Last updated
05/02/2012
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