Individual
GARRY P. DIETER
Active
Individual
GARRY P. DIETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9767
MT
207LP2900X
Pain Medicine (Anesthesiology) Physician
9767
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043771
—
MT
05
—
0080240
—
MT
05
—
806528000
—
ID
05
—
8409377
—
WA
Enumeration date
07/09/2006
Last updated
09/08/2021
Update your record
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