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
Fax: (574) 233-2995
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467494393 NPPES
Indiana MEDICAID 200040300A
Indiana Other 738460TTTT
Indiana Other 351939564
Indiana Other 480019850
Indiana Other 07000803

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