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NPI Code Detail

MEDICARE: ANTHONY S DIEHL MD

MEDICARE: ANTHONY S DIEHL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician4714SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053342691
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY S DIEHL MD
Provider Business Mailing Address
First Line : 677 CATHEDRAL DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-6018
Country : US
Telephone Number : 605-343-9224
Fax Number : 605-342-1359
Provider Business Practice Location Address
First Line : 677 CATHEDRAL DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-6018
Country : US
Telephone Number : 605-343-9224
Fax Number : 605-342-1359
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 12/14/2012

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