Dieter, Damian D.
Dieter, Damian D. is an sole proprietor health care provider with primary practice located at 1608 Portage Ave , South Bend IN 46616-1740. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Dieter, Damian D. can be contacted via phone (574) 233-2966.Contact Information
Primary practice address
1608 Portage Ave
South Bend IN 46616-1740
Phone: (574) 233-2966
Fax: (574) 233-2995
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 07000803 | Indiana |
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 07000803 | Indiana |
Profile Details
NPI number | 1467494393 |
---|---|
LBN Legal business name | Dieter, Damian D. |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 12th, 2006 |
Last updated | Oct 14th, 2019 - about 5 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1467494393 | NPPES |
Indiana | MEDICAID | 200040300A | |
Indiana | Other | 738460TTTT | |
Indiana | Other | 351939564 | |
Indiana | Other | 480019850 | |
Indiana | Other | 07000803 |
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