Healthcare Provider Details

I. General information

NPI: 1851356554
Provider Name (Legal Business Name): DIANE S SPIEKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 E OSBORN RD SUITE 250
PHOENIX AZ
85014-5678
US

IV. Provider business mailing address

1313 E OSBORN RD SUITE 250
PHOENIX AZ
85014-5678
US

V. Phone/Fax

Practice location:
  • Phone: 602-265-9161
  • Fax: 602-265-1823
Mailing address:
  • Phone: 602-265-9161
  • Fax: 602-265-1823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberAZ19995
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: