Provider Demographics
NPI:1285929877
Name:REGALA, MARK VINCENT DEL FIERRO (MD)
Entity type:Individual
Prefix:DR
First Name:MARK VINCENT
Middle Name:DEL FIERRO
Last Name:REGALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARK
Other - Middle Name:VINCENT
Other - Last Name:REGALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6770 MAYFIELD RD STE 323
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2299
Mailing Address - Country:US
Mailing Address - Phone:440-312-7140
Mailing Address - Fax:
Practice Address - Street 1:6770 MAYFIELD RD STE 323
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-312-7140
Practice Address - Fax:440-312-7142
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI319303207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine