person
Ryan Diederich, MD
Plastic and Reconstructive Surgery Physician in Glen Carbon, Illinois
NPI 1942422498

Ryan Diederich is a Plastic and Reconstructive Surgery Physician based in Glen Carbon, IL and is specialized in Plastic and Reconstructive Surgery. Ryan Diederich practices in Glen Carbon, IL and has the professional credentials of MD. The NPI Number for Ryan Diederich is 1942422498 and holds a License No. 125-050203 (Illinois).

The current practice location address for Ryan Diederich is 4955 S State Route 159 Ste 1, Glen Carbon, IL and can be reached out via phone at 618-288-7855 and via fax at 618-288-7866.

Location: 4955 S State Route 159 Ste 1, Glen Carbon, IL, 62034-1907
person
Provider Profile Details
NPI Number
1942422498
Provider Name
Ryan Diederich
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
4955 S State Route 159 Ste 1, Glen Carbon, IL, 62034-1907
Phone Number
618-288-7855
Fax Number
618-288-7866
Provider Enumeration Date
05/03/2007
Last Update Date
09/14/2024
institution
Provider Business Practice Location Address Details
Address
4955 S State Route 159 Ste 1
City
State
Zip
62034-1907
Phone Number
618-288-7855
Fax Number
618-288-7866
person
Provider Business Mailing Address Details
Address
4955 S State Route 159 Ste 1
City
State
Zip
62034-1907
Phone Number
618-288-7855
Fax Number
618-288-7866
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Plastic and Reconstructive Surgery
Taxonomy
License No.
125-050203 (Illinois)
Definition
A surgeon who specializes in plastic and reconstructive surgery.
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