Dietz, Pamela M
Dietz, Pamela M is an individual health care provider with primary practice located at 1577 Congress St , Portland ME 04102. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Dietz, Pamela M can be contacted via phone (207) 662-1622.Contact Information
Primary practice address
1577 Congress St
Portland ME 04102
Phone: (207) 662-1622
Fax: (207) 774-1814
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD14921 | Maine |
Profile Details
| NPI number | 1063515146 |
|---|---|
| LBN Legal business name | Dietz, Pamela M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2006 |
| Last updated | Nov 22nd, 2013 - about 13 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 | 1063515146 | NPPES |
| New Hampshire | MEDICAID | 30207724 | |
| New Hampshire | MEDICAID | 325040099 |
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