Diederich, Ryan

Diederich, Ryan is an individual health care provider with primary practice located at 6812 State Route 162 , Maryville IL 62062-8553. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Diederich, Ryan can be contacted via phone (618) 288-7855.

Contact Information

Primary practice address
6812 State Route 162 Maryville IL 62062-8553
Phone: (618) 288-7855
Fax: (618) 288-7866
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 125-050203 Illinois

Profile Details

NPI number 1942422498
LBN Legal business name Diederich, Ryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Jan 16th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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