Healthcare Provider Details

I. General information

NPI: 1437418670
Provider Name (Legal Business Name): TIERRA D. OSEJI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3367 S MERCY RD STE 205
GILBERT AZ
85297-7604
US

IV. Provider business mailing address

9827 N 95TH ST STE 105
SCOTTSDALE AZ
85258-4591
US

V. Phone/Fax

Practice location:
  • Phone: 480-793-7720
  • Fax: 480-292-8795
Mailing address:
  • Phone: 480-860-8488
  • Fax: 480-860-8498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0079740
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number81990
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: