Provider Demographics
NPI:1932662301
Name:DIENER, KARL WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:WILLIAM
Last Name:DIENER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9317
Mailing Address - Country:US
Mailing Address - Phone:585-267-6341
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR RM 4601
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-598-0430
Practice Address - Fax:304-598-0430
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program