Provider Demographics
NPI:1114006053
Name:HERMAN, DIANA M (MD,)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:M
Last Name:HERMAN
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15255 N 40TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4636
Mailing Address - Country:US
Mailing Address - Phone:602-867-2690
Mailing Address - Fax:602-404-1904
Practice Address - Street 1:15255 N 40TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4636
Practice Address - Country:US
Practice Address - Phone:602-867-2690
Practice Address - Fax:602-404-1904
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ14788207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology