Individual
DALE DARWIN DIEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
202 PROSPECT DR, GLENDIVE, MT 59330-1943
(406) 345-3306
Mailing address
PO BOX 46, EKALAKA, MT 59324-0046
(406) 775-8738
(406) 775-6479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
166
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0437606
—
MT
01
—
93083
BLUE CROSS
MT
Enumeration date
01/08/2007
Last updated
02/14/2024
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