Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARTIN LEE DIERKS JR., IDC
ActiveMARTIN LEE DIERKS JR., IDC is a Independent Duty Corpsman healthcare provider located in DE SOTO, Missouri. NPI 1902132434 is currently active in the NPPES registry. Verify at CMS.
Independent Duty Corpsman · DE SOTO, MO
Registration Details
- NPI Number
- 1902132434
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 17, 2009 (16.784606142783 yrs)
- Last Updated
- Oct 17, 2009
Practice Information
- Address
-
2915 PARTHENON DRDE SOTO, MO, 630204645Browse MO providers · Browse ZIP 63020
- Phone
- 7576508436
- Primary Specialty
-
Independent Duty Corpsman
1710I1002X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.