Provider Demographics
NPI:1598861718
Name:DIAMOND, CHERYL BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL BETH
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 E HISTORIC ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701-2866
Mailing Address - Country:US
Mailing Address - Phone:520-818-6543
Mailing Address - Fax:
Practice Address - Street 1:494 E HISTORIC ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-2866
Practice Address - Country:US
Practice Address - Phone:520-818-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207282084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20728OtherMEDICAL LICENSE
AZ007546OtherAHCCCS
AZ20728OtherMEDICAL LICENSE