{
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"LastName": null,
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"FirstLineMailingAddress": "1300 E MARKET ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "YORK",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "17403-1251",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "717-843-4844",
"MailingAddressFaxNumber": "717-854-5288",
"FirstLinePracticeLocationAddress": "1300 E MARKET ST",
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"PracticeLocationAddressCityName": "YORK",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "717-843-4844",
"PracticeLocationAddressFaxNumber": "717-854-5288",
"EnumerationDate": "11/21/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIETRICH",
"AuthorizedOfficialFirstName": "MALCOLM",
"AuthorizedOfficialMiddleName": "HOWARD",
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"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.O.",
"AuthorizedOfficialTelephoneNumber": "717-843-4844",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207QA0505X",
"TaxonomyName": "Adult Medicine Physician",
"LicenseNumber": "OS002279L",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}