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General NPI Number Information
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NPI Number | 1184643306
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Entity Type | Individual
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Provider Name | DIANA DENISE HEARD MD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 12/13/2018
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Provider Practice Location Address
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Address Line | 5750 W THUNDERBIRD ROAD SUITE D400
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City | GLENDALE
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State | AZ
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Zip | 85306
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Country | US
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Telephone | 602-298-8977
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Fax | 602-298-1787
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Provider Business Mailing Address
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Address Line | 5750 W THUNDERBIRD ROAD SUITE D400
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City | GLENDALE
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State | AZ
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Zip | 85306
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Country | US
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Telephone | 602-298-8977
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Fax | 602-298-1787
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301079540
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 40357
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License Number State | AZ
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