Michael Morgan Dietch III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

58573 Issued in FL

Practice address

3875 S Nova Rd
Port Orange, FL 32127-4950

Phone

(386) 322-9244

Fax

(386) 788-9776

NPI assigned

Jul 28, 2006

Last updated

Aug 20, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spruce Creek Family Care

  • Family Medicine Physician
  • Port Orange, FL
  • NPI 1700064102
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1043224538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274950",
            "telephone_number": "386-322-9244",
            "fax_number": "386-788-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274950",
            "telephone_number": "386-322-9244",
            "fax_number": "386-788-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETCH III",
        "first_name": "MICHAEL",
        "middle_name": "MORGAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "58573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amrik Dhaliwal
• Diamond Heart Inc
• Diamond Heart Inc
• Amanda J Diaz, L.M.T.
• Paula Christina Dichiara, LMFT
• Kaitlyn Dietrich
• Tina Marie Digiovanni, DC
• Brianna Dillard
• Haleigh Elisabeth Dillender, BCBA
• Georgi Stamatov Dimov, DC

• Family Medicine Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.