Individual
DR. JEFFREY ALAN DITESHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
9501222
NC
Other
Enumeration date
12/19/2005
Last updated
12/01/2008
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