DR. JEFFREY ALAN DITESHEIM M.D. NPI 1780660019

NPI Information

NPI: 1780660019
Provider Name: DR. JEFFREY ALAN DITESHEIM, M.D.
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

Address:
9336 BLAKENEY CENTER DRIVE
SUITE 130
CHARLOTTE, NC
ZIP 28277
Phone: (704) 542-8686
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DR. Jeffrey Alan Ditesheim, M.D. is a plastic and reconstructive surgery surgery in Charlotte, NC. The provider is a surgeon who specializes in plastic and reconstructive surgery. DR. Jeffrey Alan Ditesheim, M.D. NPI is 1780660019. 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:

9336 BLAKENEY CENTER DRIVE
SUITE 130
CHARLOTTE, NC
ZIP 28277
Phone: (704) 542-8686
Fax: (704) 542-8696

The enumeration date for this NPI number is 12/19/2005 and was last updated on 12/1/2008.

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	2086S0122X	Surgery	Plastic and Reconstructive Surgery	9501222	NORTH CAROLINA	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	2217077A	MEDICARE ID-TYPE UNSPECIFIED	NORTH CAROLINA
2	G16740	MEDICARE UPIN	NORTH CAROLINA

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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