Dr. Christopher T Dietrich
Physical Medicine & Rehabilitation Doctor
1136 Jackson Blvd
Rapid City
, South Dakota 57702-4335
Dr. Christopher T Dietrich
Physical Medicine & Rehabilitation Doctor
1136 Jackson Blvd
Rapid City
, South Dakota 57702-4335
(605) 341-4501
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About
Features
Specialties
- Physical Medicine & Rehabilitation Doctor
Languages spoken
- English
Location
First Address
- Dr. Christopher T Dietrich
- 1136 Jackson Blvd
- Rapid City, SD
- Zip : 57702-4335
- Fax : (605) 341-4501
- Phone : (605) 721-7246
Second Address
- Dr. Christopher T Dietrich
- 1136 Jackson Blvd
- Rapid City, SD
- Zip : 57702-4335
- Fax : (605) 341-4501
- Phone : (605) 721-7246
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 5661 | SD |
National Provider Identifier
| NPI | 1063403905 |
|---|---|
| Provider Name | Dr. Christopher T Dietrich |
| First Address | Rapid City, SD 57702-4335 |
| Second Address | Rapid City, SD 57702-4335 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/10/2005 |
| Last Update Date | 10/01/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0006332 | WELLMARK BCBS (01) | SD |
| 0100322 | WELLMARK BCBS (01) | SD |
| 0122767 | MEDICA (01) | SD |
| 1063403905 | (05) | SD |
| 115322600 | WYOMING MEDICAID (01) | SD |
| 121334200 | WYOMING MEDICAID (01) | SD |
| 41194500700 | NEBRASKA MEDICAID (01) | SD |
| 45827 | SANFORD HEALTH PLAN (01) | SD |
| 5661 | DAKOTACARE (01) | SD |
| H61532 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.