Individual
MRS. ALISON L. DIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10324 OLD OCEAN CITY BLVD., BERLIN, MD 21811
(410) 629-0041
(410) 629-0544
Mailing address
10324 OLD OCEAN CITY BLVD., BERLIN, MD 21811
(410) 629-0041
(410) 629-0544
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C05717
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05717
MD MEDICAL LICENSE
MD
Enumeration date
03/27/2015
Last updated
06/22/2021
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