Provider Demographics
NPI:1346408994
Name:DIETER, ALEXIS ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:ANNE
Last Name:DIETER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:106 IRVING ST NW STE 405
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2989
Mailing Address - Country:US
Mailing Address - Phone:202-877-6526
Mailing Address - Fax:202-877-0530
Practice Address - Street 1:106 IRVING ST NW STE 405
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2989
Practice Address - Country:US
Practice Address - Phone:984-974-0496
Practice Address - Fax:984-974-0499
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-00453207V00000X
DCMD048243207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology