| Dale Darwin Diede, PAC | |
|
202 Prospect Dr, Glendive, MT 59330-1943 | |
| (406) 345-3306 | |
| Not Available |
| Full Name | Dale Darwin Diede |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 202 Prospect Dr, Glendive, Montana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922156421 | NPI | - | NPPES |
| 93083 | Other | MT | BLUE CROSS |
| 0437606 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 166 (Montana) | Primary |
| Entity Name | Glendive Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033129622 PECOS PAC ID: 7214846823 Enrollment ID: O20031103000338 |
| Entity Name | Fallon Medical Complex Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386700763 PECOS PAC ID: 0941119499 Enrollment ID: O20040614000391 |
| Entity Name | Dahl Memorial Healthcare Association Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801065396 PECOS PAC ID: 1658323373 Enrollment ID: O20050210000566 |
| Entity Name | Glendive Medical Center Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1376552893 PECOS PAC ID: 7214846823 Enrollment ID: O20061104000114 |
| Mailing Address | Practice Location Address |
|---|---|
| Dale Darwin Diede, PAC Po Box 46, Ekalaka, MT 59324-0046 Ph: (406) 775-8738 | Dale Darwin Diede, PAC 202 Prospect Dr, Glendive, MT 59330-1943 Ph: (406) 345-3306 |
Samuel C Mintz, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |
Rodney Hickman, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |
David L Nieman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 Dilworth St, Glendive, MT 59330 Phone: 406-345-8935 Fax: 406-345-8908 |
Jack W. Haas, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |
Ms. Audrey J. Kerr, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3314 Fax: 406-345-3324 |
Sandra Janzen, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |
Carleen Gaub, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 Dilworth St, Glendive, MT 59330 Phone: 406-345-8900 Fax: 406-345-8908 |