Provider Demographics
NPI:1740284207
Name:NAGY, RONALD ALVA (DPM)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:ALVA
Last Name:NAGY
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 1:555 N GILBERT RD
Mailing Address - Street 2:STE 102
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-7551
Mailing Address - Country:US
Mailing Address - Phone:480-833-4728
Mailing Address - Fax:480-898-8847
Practice Address - Street 1:555 N GILBERT RD
Practice Address - Street 2:STE 102
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-7551
Practice Address - Country:US
Practice Address - Phone:480-833-4728
Practice Address - Fax:480-898-8847
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0237213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0068690OtherBCBS PROVIDER NUMBER
AZ1Z0307OtherHEALTHNET PROVIDER NUMBER
AZ4329197OtherAETNA PROVIDER NUMBER
AZ442640OtherAHCCCS PROVIDER NUMBER
AZAZ0068690OtherBCBS PROVIDER NUMBER
AZZ20376Medicare ID - Type Unspecified