Individual
DR. PATRICK A DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3474
(607) 547-6553
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(607) 547-3474
(607) 547-6553
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
139208
NY
2086S0102X
Surgical Critical Care Physician
139208
NY
2086S0129X
Vascular Surgery Physician
Primary
139208
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01162481
—
NY
Enumeration date
04/12/2006
Last updated
03/31/2008
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