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Individual

PAUL D DIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
830 PENNSYLVANIA AVE, SUITE 104, CHARLESTON, WV 25302-3302
(304) 388-1552
Mailing address
830 PENNSYLVANIA AVE, SUITE 104, CHARLESTON, WV 25302-3302
(304) 388-1552

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20953
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810001038
WV
Enumeration date
01/12/2006
Last updated
03/17/2014
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