Ryan S. Diederich, MD PC
Ryan S. Diederich, MD PC is a Plastic and Reconstructive Surgery Physician in Glen Carbon, Illinois. Registered with an NPI since 2022.
- In the registry since
- 2022
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
4955 S State Route 159 # 1Glen Carbon, IL 62034-1907
Phone: (618) 288-7855
Fax: (618) 288-7866
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Specialties & licences
| Plastic and Reconstructive Surgery Physician (primary) | Taxonomy 2086S0122X |
|---|
Record details
| NPI number | 1639817182 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ryan Diederich — Owner · (618) 288-7855 |
| Other names | Midamerica Plastic Surgery |
| NPI enumerated | May 24, 2022 |
| Last updated in NPPES | May 24, 2022 |
| Certification date | May 24, 2022 |
| Mailing address | 4955 S State Route 159 # 1, Glen Carbon, IL 62034-1907 |
Other providers in Glen Carbon
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Ryan Diederich, MD
4955 S State Route 159 Ste 1, Glen Carbon, IL 62034-1907 · (618) 288-7855