Dieter, Jonathan L
Dieter, Jonathan L is an sole proprietor health care provider with primary practice located at 8014 Myrtle Trace Dr , Conway SC 29526-8945. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dieter, Jonathan L can be contacted via phone (843) 347-7224.Contact Information
Primary practice address
8014 Myrtle Trace Dr
Conway SC 29526-8945
Phone: (843) 347-7224
Fax: (843) 347-7335
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 7055 | South Carolina |
Profile Details
| NPI number | 1205987419 |
|---|---|
| LBN Legal business name | Dieter, Jonathan L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 15th, 2007 |
| Last updated | Oct 10th, 2007 - about 17 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 | 1205987419 | NPPES |
| South Carolina | MEDICAID | PC4269 |
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