DR. CHERI DIANE DERSAM


Address: 4730 E Indian School Rd, Suite 211, Phoenix, AZ 85018-5441
Phone: 6023543491

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207P00000X Emergency Medicine 31114 AZ Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AZ 77634604 05

Office Location

Street Address 4730 E INDIAN SCHOOL RD
SUITE 211
City PHOENIX
State AZ
Zip Code 85018-5441

Providers in the same location

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

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NPI Name Taxonomy Address Enumeration
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1902322472 Saskia Soliz Behavioral Analyst 2940 N 40th Street, Unit 19, Phoenix, AZ 85018 2017-08-16
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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
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Taxonomy Information

Taxonomy Code 207P00000X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City PHOENIX
Zip Code 85018

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Dataset Information

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.

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