Jonathan Lucas Dieter Jr. (NPI# 1205987419, PAC ID# 8527192343) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1205987419 |
| PAC ID by PECOS | 8527192343 |
| Professional Enrollment ID | I20100816001016 |
| Full Name | Jonathan Lucas Dieter Jr. |
| Address |
3300 4th Ave Conway SC 29527-6002 |
| Gender | M |
| Medical School | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Graduation Year | 1973 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420049 | CONWAY MEDICAL CENTER |
| 420020 | TIDELANDS HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 3300 4th Ave, Conway, SC 29527-6002 |
| Street Address |
3300 4TH AVE |
| City | CONWAY |
| State | SC |
| Zip | 29527-6002 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan Conroy | Occupational Therapy | The Weston Group of South Carolina Inc | 2310 Hwy 378, Conway, SC 29527-4911 |
| Devin A Simmons | Qualified Speech Language Pathologist | The Weston Group of South Carolina Inc | 2310 Hwy 378, Conway, SC 29527-4911 |
| Kerry A Murphy | Occupational Therapy | The Weston Group of South Carolina Inc | 2310 Hwy 378, Conway, SC 29527-4911 |
| Kimberly D Hunsucker | Nurse Practitioner | Conway Hospital Community Services | 1301 Creel St, Conway, SC 29527-5018 |
| Michele G Lively | Nurse Practitioner | Conway Hospital Community Services | 1301 Creel St, Conway, SC 29527-5018 |
| City | CONWAY |
| Zip Code | 29527 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | CONWAY + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jonathan Lucas Dieter Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.