Individual
GLENN R DEIBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 W CHANDLER BLVD, CHANDLER, AZ 85224-6145
(480) 821-7565
Mailing address
1717 W CHANDLER BLVD, CHANDLER, AZ 85224-6145
(480) 821-7565
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14416
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171918
—
AZ
Enumeration date
01/13/2006
Last updated
12/29/2011
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