Provider Demographics
NPI:1386095131
Name:LE, DIEN VIET (MD)
Entity type:Individual
Prefix:DR
First Name:DIEN
Middle Name:VIET
Last Name:LE
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 1:10 TIMBERVIEW LN STE 2
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:PA
Mailing Address - Zip Code:16345-4150
Mailing Address - Country:US
Mailing Address - Phone:814-757-6505
Mailing Address - Fax:814-757-4310
Practice Address - Street 1:10 TIMBERVIEW LN STE 2
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:PA
Practice Address - Zip Code:16345-4150
Practice Address - Country:US
Practice Address - Phone:814-837-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH23342207R00000X
RIMD18798207R00000X
PAMD478943207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1043211380001Medicaid
PA1041053260003Medicaid