Dietrich, Gregory Dean
Dietrich, Gregory Dean is an individual health care provider with primary practice located at 320 Warner Drive , Lewiston ID 83501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as his primary health care specialty. Dietrich, Gregory Dean can be contacted via phone (208) 743-3523.Contact Information
Primary practice address
320 Warner Drive
Lewiston ID 83501
Phone: (208) 743-3523
Fax: (208) 746-8741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | 00034506 | Washington |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | M7482 | Idaho |
Profile Details
| NPI number | 1306831698 |
|---|---|
| LBN Legal business name | Dietrich, Gregory Dean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2005 |
| Last updated | Jun 24th, 2016 - about 10 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 | 1306831698 | NPPES |
| Idaho | Other | 74823 | BCI |
| Idaho | MEDICAID | 805208800 | BCI |
| Idaho | Other | 000010004322 | BCI |
| Idaho | MEDICAID | 8204851 | BCI |
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