Provider Demographics
NPI:1891180816
Name:DUGAL, NARESH KUMAR (DPM)
Entity Type:Individual
Prefix:DR
First Name:NARESH
Middle Name:KUMAR
Last Name:DUGAL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 E DEER VALLEY DR UNIT 333
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-5669
Mailing Address - Country:US
Mailing Address - Phone:626-290-8091
Mailing Address - Fax:
Practice Address - Street 1:9755 N 90TH ST STE C120
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5174
Practice Address - Country:US
Practice Address - Phone:626-290-8091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018017440213EP1101X
KS12-00444213EP1101X
390200000X
AZ000978213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program