Individual
DR. SUSAN JOANNE DIEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
516 DELAWARE STREET SE, PWB THIRD FLOOR CLINIC 3A, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 884-0999
Mailing address
420 DELAWARE STREET, MMC 741 UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-4426
(612) 624-3189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39957
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-00788
MEDICA CHOICE & PRIMARY
MN
05
—
0995043
—
IA
01
—
1015996
PREFERRED ONE
MN
01
—
120995
UCARE
MN
01
—
12R06DI
BCBS
MN
05
—
699813500
—
MN
01
—
768087
ARAZ
MN
01
—
HP28827
HEALTHPARTNERS
MN
Enumeration date
06/29/2006
Last updated
10/25/2012
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