Dietels, Guy Andrew

Dietels, Guy Andrew is an individual health care provider with primary practice located at 1455 Towne Square Blvd Nw , Roanoke VA 24012-1612. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Dietels, Guy Andrew can be contacted via phone (540) 265-0595.

Contact Information

Primary practice address
1455 Towne Square Blvd Nw Roanoke VA 24012-1612
Phone: (540) 265-0595
Fax: (540) 265-0596
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 061800456 Virginia

Profile Details

NPI number 1902855414
LBN Legal business name Dietels, Guy Andrew
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jul 18th, 2008 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1902855414 NPPES
Virginia Other 487193 NVA PROVIDER #
Virginia MEDICAID 009230645 NVA PROVIDER #
Virginia Other 224243 NVA PROVIDER #
Virginia Other 5709659 NVA PROVIDER #

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