Terry J Dietrich, MD
Orthopaedic Surgery in New London, WI. Individual provider (NPI-1).
NPI number1245274141
StatusActive
Last updated in NPPESNov 23, 2011
Details
- NPI
- 1245274141
- Entity type
- Individual (NPI-1)
- Name
- Terry J Dietrich
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 15, 2006
- Last updated
- Nov 23, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 49333-020 | WI | Yes |
Practice location
1405 Mill StNew London, WI 54961-2155
Phone 920-831-5050
Mailing address
Po Box 8003Appleton, WI 54912-8003
Phone 920-996-3298 · Fax 920-738-5787
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