Terry J Dietrich, MD is a
Orthopaedic Surgery physician based in New London, Wisconsin. Terry J Dietrich is licensed to practice in Wisconsin (license number 49333-020) and his current practice location is 1405 Mill St, New London, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(920) 831-5050.
NPI number for Terry J Dietrich is 1245274141 and his current mailing address is Po Box 8003, Appleton, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1245274141.
Physician's Profile
| Full Name | Terry J Dietrich |
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| Gender | Male |
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| Speciality | Orthopaedic Surgery |
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| Location | 1405 Mill St, New London, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1245274141
- Provider Enumeration Date: 06/15/2006
- Last Update Date: 11/23/2011
Medical Identifiers
Medical identifiers for Terry J Dietrich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245274141 | NPI | - | NPPES |
| 450030720 | Other | WI | MEDICARE PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207X00000X | Orthopaedic Surgery | 49333-020 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Terry J Dietrich is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Terry J Dietrich, MD
Po Box 8003,
Appleton, WI 54912-8003
Ph: (920) 996-3298 | Terry J Dietrich, MD
1405 Mill St,
New London, WI 54961-2155
Ph: (920) 831-5050 |
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