Michael V Dieter, OD | |
12000 Elm Creek Blvd N Ste L90, Maple Grove, MN 55369-7168 | |
(763) 416-0919 | |
(763) 416-0992 |
Full Name | Michael V Dieter |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 12000 Elm Creek Blvd N Ste L90, Maple Grove, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245374115 | NPI | - | NPPES |
1396DI | Other | MN | BLUE CROSS BLUE SHIELD |
844323800 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1693 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
---|---|
Michael V Dieter, OD 12000 Elm Creek Blvd N Ste L90, Maple Grove, MN 55369-7168 Ph: (763) 416-0919 | Michael V Dieter, OD 12000 Elm Creek Blvd N Ste L90, Maple Grove, MN 55369-7168 Ph: (763) 416-0919 |
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