MEDICARE: DR. GARY L DIER 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
1	2085R0202X	Diagnostic Radiology Physician	35087821	OH
2	2085R0202X	Diagnostic Radiology Physician	271141	NY
3	2085R0202X	Diagnostic Radiology Physician	MD042743E	PA
4	2085R0202X	Diagnostic Radiology Physician	36172	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00152920	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	136F6	OTHER	NC	BC BS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518966118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY L DIER MD

Provider Business Mailing Address
First Line	:	100 E CAMPUS VIEW BLVD STE 100
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-8628
Country	:	US
Telephone Number	:	330-569-7782
Fax Number	:	330-596-7791

Provider Business Practice Location Address
First Line	:	200 E STATE ST
Second Line	:
City	:	ALLIANCE
State	:	OH
Zip	:	44601-4936
Country	:	US
Telephone Number	:	330-596-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	01/21/2025

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Directions to “ DR. GARY L DIER MD” Practice Location

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