DR. CHERI DIANE DERSAM (NPI# 1811905177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811905177 |
| Entity Type | Individual |
| Full Name | DR. CHERI DIANE DERSAM |
| Credential | M.D. |
| Practice Address |
4730 E Indian School Rd Suite 211 Phoenix AZ 85018-5441 |
| Mailing Address |
6131 E Calle Rosa Scottsdale AZ 85251-4222 |
| Practice Telephone | 6023543491 |
| Mailing Telephone | 4808745835 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 31114 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 77634604 | 05 |
| Street Address |
4730 E INDIAN SCHOOL RD SUITE 211 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85018-5441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255325197 | John N. Harman Iv | Dentist | 4730 E Indian School Rd, Suite 210, Phoenix, AZ 85018-5441 | 2005-09-07 |
| 1417359894 | Deion Tran | Physician Assistant | 4730 E Indian School Rd, Suite #211, Phoenix, AZ 85018-5441 | 2014-09-17 |
| 1912137456 | Michael William Hickman | Emergency Medicine | 4730 E Indian School Rd, #211, Phoenix, AZ 85018-5441 | 2009-07-17 |
| 1447415427 | Mary Elizabeth Young | Emergency Medicine | 4730 E Indian School Rd, Suite 211, Phoenix, AZ 85018-5441 | 2008-07-19 |
| 1801997077 | Emurgent Care Pllc | Clinic/Center | 4730 E Indian School Rd, Suite 211, Phoenix, AZ 85018-5441 | 2006-09-26 |
| 1265479950 | Bradley Steven Butler | Emergency Medicine | 4730 E Indian School Rd, Suite 211, Phoenix, AZ 85018-5441 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467098483 | Skyfalls LLC | Plastic Surgery | 3723 E Sells Drive, Phoenix, AZ 85018 | 2019-11-25 |
| 1568944148 | Avicenna Integrative Medicine Plc | Internal Medicine | 4429 N 44th St, Phoenix, AZ 85018 | 2018-08-30 |
| 1124547682 | Consulting Options, LLC | Orthopaedic Surgery | 5110 North 44th Street, Suite L200, Phoenix, AZ 85018 | 2017-09-15 |
| 1902322472 | Saskia Soliz | Behavioral Analyst | 2940 N 40th Street, Unit 19, Phoenix, AZ 85018 | 2017-08-16 |
| 1700233418 | Harriet Frost | Marriage & Family Therapist | 4500 N. 32nd Street, Suite 100-d, Phoenix, AZ 85018 | 2016-05-23 |
| 1356733547 | Margaret Murphy Conley | Acupuncturist | 3040 N 44th St Ste 3, Phoenix, AZ 85018 | 2015-02-24 |
| 1457766792 | Anne Marie Hatch | Psychiatry & Neurology | 5090 N 40th St Ste 250a, Phoenix, AZ 85018 | 2014-06-25 |
| 1972848315 | Crystal M Ostermeyer | Physician Assistant | 4350 East Camelback Rd, Suite G-100, Phoenix, AZ 85018 | 2012-12-11 |
| 1699029652 | Monte Vista School | Local Education Agency (LEA) | 3501 E. Osborn Road, Phoenix, AZ 85018 | 2012-10-30 |
| 1962754028 | Jill R. Zweig D.o., PC | Psychiatry & Neurology | 5110 N 40th Street, Suite 104, Phoenix, AZ 85018 | 2012-10-12 |
| Find all providers in zip 85018 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627815 | Fep Ncch | Emergency Medicine | 8825 N 23rd Ave Ste 100, Phoenix, AZ 85021-4148 | 2020-10-22 |
| 1669861423 | Arthur Barker | Emergency Medicine | 4205 W Reddie Loop, Phoenix, AZ 85083-1610 | 2015-01-16 |
| 1326481102 | Adrienne R Azurdia | Emergency Medicine | 4237 E Liberty Ln, Phoenix, AZ 85048-0537 | 2013-04-11 |
| 1538401930 | Hannah Malashock | Emergency Medicine | 129 W Coronado Rd, Phoenix, AZ 85003-1144 | 2013-03-23 |
| 1982977922 | Robert Ellis George | Emergency Medicine | 1011 W. Golden Ln., Phoenix, AZ 85021 | 2012-02-22 |
| 1588972889 | Glenn Richard Kunsman | Emergency Medicine | 3507 N Central Ave Ste 403, Phoenix, AZ 85012-2124 | 2010-09-21 |
| 1073849501 | Melissa Denny | Emergency Medicine | 4225 E Mcdowell Rd Apt 1039, Phoenix, AZ 85008-4418 | 2009-10-17 |
| 1700111689 | Rachel Levitan | Emergency Medicine | 2601 E. Roosevelt, Department of Emergency Medicine, Phoenix, AZ 85008 | 2009-10-09 |
| 1891029328 | Patrick Godwin | Emergency Medicine | 5045 E Oneida St, Phoenix, AZ 85044-3325 | 2009-09-30 |
| 1689802209 | Robert John Mintz | Emergency Medicine | 9225 N 3rd St Ste 307, Phoenix, AZ 85020-2466 | 2009-06-23 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.