Dianna Lynne Fury, MD
Individual provider Active NPI Family Medicine Physician · Bernalillo, NM
NPI 1790784973 · NPPES record last updated Dec 12, 2016
Key facts
- NPI
- 1790784973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD2011-0163 (NM)
- Practice address
- 203 Sandia Day School Road
Bernalillo, NM 87004 - Phone
- (505) 867-4696
- Fax
- (505) 867-4997
- NPI assigned
- Jul 19, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30414 | CO | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 30414 | CO | |
| Family Medicine Physician | 207Q00000X | MD2011-0163 | NM | Yes |
Addresses
Primary practice location
203 Sandia Day School Road
Bernalillo, NM 87004
Mailing address
481 Sandia Loop
Bernalillo, NM 87004-7076
Phone (505) 867-4696
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07235551 | Medicaid | NM |
Other providers in Bernalillo, NM
- William Philip Fleming
- Robert Ryan Fontenot
- Julia Fox
- Megan Friedman
- Arthur Fuldauer
- Marian Gaisthia
- Amanda Gonzales
- Angela Dawn Gonzales
- Maria C. Gonzales
- Mariah Gonzales
All providers in Bernalillo, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.