Individual
MRS. AMANDA N DIEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 PINE ST, RAPID CITY, SD 57701-1669
(605) 721-8939
Mailing address
350 PINE ST, RAPID CITY, SD 57701-1669
(605) 721-8939
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4739
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4993484
WELLMARK
SD
05
—
6700462
—
SD
05
—
6700463
—
SD
01
—
9213203
DAKOTACARE
SD
Enumeration date
10/12/2006
Last updated
12/01/2015
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