Individual provider · Type 1 NPI

Peyton Gabriel Dietz

Surgical Physician Assistant · Creve Coeur, MO

NPI number 1750290193 Active

Practice location

621 S New Ballas Rd Ste 560A
Creve Coeur, MO 63141-8261

Mailing address

375 Misty Valley Dr
St. Peters, MO 63376-5325

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1750290193

Peyton Gabriel Dietz's National Provider Identifier is 1750290193, issued on Sep 2, 2026. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Creve Coeur, MO. The record was last updated on Sep 2, 2026.