Gary D Diederich, MD is a medicare enrolled "Family Medicine" physician in Bristol, New Hampshire. His current practice location is
859 Lake St, Bristol, New Hampshire. You can reach out to his office (for appointments etc.) via phone at
(603) 744-6200.
Gary D Diederich is licensed to practice in New Hampshire (license number 6515) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1720029259.
Physician's Profile
| Full Name | Gary D Diederich |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 859 Lake St, Bristol, New Hampshire |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Gary D Diederich attended and graduated from in
NPI Data:
- NPI Number: 1720029259
- Provider Enumeration Date: 06/08/2006
- Last Update Date: 11/30/2007
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Gary D Diederich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720029259 | NPI | - | NPPES |
| 80000321 | Medicaid | NH | |
| RE4060 | Other | NH | MEDICARE GROUP |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 6515 (New Hampshire) | 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. Gary D Diederich is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Gary D Diederich, MD
101 Boulder Point Dr, Suite 1,
Plymouth, NH 03264
Ph: (603) 536-4000 | Gary D Diederich, MD
859 Lake St,
Bristol, NH 03222-4506
Ph: (603) 744-6200 |
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