DR. MARVIN LEROY DIETRICH M.D. NPI 1619925401

NPI Information

NPI: 1619925401
Provider Name: DR. MARVIN LEROY DIETRICH, M.D.
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Individual

Specialization: Gynecology

Address:
10503 W THUNDERBIRD BLVD
#301
SUN CITY, AZ
ZIP 85351
Phone: (623) 974-3647
Get Directions

DR. Marvin Leroy Dietrich, M.D. is a gynecology obstetrics gynecology in Sun City, AZ. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee DR. Marvin Leroy Dietrich, M.D. NPI is 1619925401. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10503 W THUNDERBIRD BLVD
#301
SUN CITY, AZ
ZIP 85351-022
Phone: (623) 974-3647
Fax: (623) 977-0310

The enumeration date for this NPI number is 5/4/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VG0400X	Obstetrics & Gynecology	Gynecology	27044	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11172652	OTHER	ARIZONA	CAQH UNIVERSAL PROVIDER #
2	11541	OTHER	NEBRASKA	STATE LICENSE
3	6248578-004	OTHER	ARIZONA	CIGNA
4	27044	OTHER	ARIZONA	STATE LICENSE
5	AZ0885510	OTHER	ARIZONA	AZ BC/BS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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