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

Ryan Diederich is a Plastic and Reconstructive Surgery Physician based in Maryville, IL and is specialized in Plastic and Reconstructive Surgery. Ryan Diederich practices in Maryville, 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 6812 State Route 162, Maryville, IL and can be reached out via phone at 618-288-7855 and via fax at 618-288-7866. You can also correspond with Ryan Diederich through the mailing address at 6810 STATE ROUTE 162, MARYVILLE, IL - 62062-8501 (mailing address contact number: 618-391-6405).

Location: 6812 State Route 162, Maryville, IL, 62062-8501
person
Provider Profile Details
NPI Number
1942422498
Provider Name
Ryan Diederich
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
6812 State Route 162, Maryville, IL, 62062-8501
Phone Number
618-288-7855
Fax Number
618-288-7866
Provider Enumeration Date
05/03/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6812 State Route 162
City
State
Zip
62062-8553
Phone Number
618-288-7855
Fax Number
618-288-7866
person
Provider Business Mailing Address Details
Address
6810 State Route 162
City
State
Zip
62062-8501
Phone Number
618-391-6405
Fax Number
618-288-4088
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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