Ryan S. Diederich, MD PC
NPI #1639817182 in Glen Carbon, Illinois
Provider Information
- NPI Number
- 1639817182
- Entity Type
- Organization
- Organization Name
- Ryan S. Diederich, MD PC
- Primary Specialty
- Surgery - Plastic and Reconstructive Surgery
- Enumeration Date
- May 24, 2022
- Last Updated
- May 24, 2022
Practice Location
- Address
- 4955 S STATE ROUTE 159 # 1
- City
- Glen Carbon
- State
- Illinois
- ZIP Code
- 62034-1907
- Phone
- (618) 288-7855
Authorized Official
- Name
- RYAN S DIEDERICH, MD
- Title
- OWNER
- Phone
- (618) 288-7855
Specialties & Taxonomy Codes
| Specialty |
|---|
| Surgery - Plastic and Reconstructive Surgery — Plastic and Reconstructive Surgery |
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