Provider Demographics
NPI:1295805240
Name:PAPKE, DIANE T (MD)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:T
Last Name:PAPKE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3003 N CENTRAL AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2904
Mailing Address - Country:US
Mailing Address - Phone:602-952-3400
Mailing Address - Fax:602-952-3401
Practice Address - Street 1:3311 N 44TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-6446
Practice Address - Country:US
Practice Address - Phone:602-957-2220
Practice Address - Fax:602-957-1750
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2015-05-20
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Provider Licenses
StateLicense IDTaxonomies
AZ329572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ954637Medicaid
AZI41420Medicare UPIN
AZ954637Medicaid