Provider Demographics
NPI:1780735571
Name:NARDELLA, FRANCIS A (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:A
Last Name:NARDELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 N MAIN ST
Mailing Address - Street 2:STE 200
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1165
Mailing Address - Country:US
Mailing Address - Phone:480-451-6860
Mailing Address - Fax:480-451-6769
Practice Address - Street 1:900 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-1900
Practice Address - Country:US
Practice Address - Phone:207-907-3370
Practice Address - Fax:207-907-1189
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-17331207RR0500X
MEMD24156207RR0500X
MEEL201705207RR0500X
AZ20026174400000X
MN58987207RR0500X
OH35.138856207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZMD 20026Medicare ID - Type Unspecified
AZA66174Medicare UPIN