Dr THOMAS J DIETRICH MD is a male medical professional, specializing in Emergency Medicine. He graduated in 1996 from Pennsylvania State University College Of Medicine.
LAKE COUNTRY EMERGENCY PHYSICIANS
791 SUMMIT AVE
OCONOMOWOC
WI
530663844
Tel: 2625690251
| Npi | 1912959446 |
| Pac Id | 4688569072 |
| Professional Enrollment Id | I20040216000780 |
| Last Name | DIETRICH |
| First Name | THOMAS |
| Middle Name | J |
| Suffix | |
| Gender | M |
| Credential | MD |
| Medical School Name | PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | EMERGENCY MEDICINE |
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| Organization Legal Name | LAKE COUNTRY EMERGENCY PHYSICIANS |
| Group Practice Pac Id | 4385607555 |
| Number Of Group Practice Members | 6 |
| Line 1 Street Address | 791 SUMMIT AVE |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | OCONOMOWOC |
| State | WI |
| Zip Code | 530663844 |
| Phone Number | 2625690251 |
| Hospital Affiliation Ccn 1 | 520062 |
| Hospital Affiliation Lbn 1 | OCONOMOWOC MEMORIAL HOSPITAL |
| Hospital Affiliation Ccn 2 | 520027 |
| Hospital Affiliation Lbn 2 | COLUMBIA ST MARYS HOSPITAL OZAUKEE |
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| Professional Accepts Medicare Assignment | Y |
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