Provider Demographics
NPI:1912534637
Name:DREGELY, ADAM ZOLTAN
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:ZOLTAN
Last Name:DREGELY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 E CHILTON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-5007
Mailing Address - Country:US
Mailing Address - Phone:480-352-5728
Mailing Address - Fax:
Practice Address - Street 1:1440 S CLEARVIEW AVE STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3381
Practice Address - Country:US
Practice Address - Phone:480-689-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program