Provider Demographics
NPI:1003050915
Name:DIETRICH-MCLEAN, MARSHA SIGRID (DO)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:SIGRID
Last Name:DIETRICH-MCLEAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:MARSHA
Other - Middle Name:SIGRID
Other - Last Name:DIETRICH-MCLEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:201 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16550-0001
Mailing Address - Country:US
Mailing Address - Phone:814-877-4922
Mailing Address - Fax:814-877-3622
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0001
Practice Address - Country:US
Practice Address - Phone:814-877-4922
Practice Address - Fax:814-877-3622
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS020402207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine