Organization
EVANGELISTA MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADELBERT D EVANGELISTA MD (PRESIDENT)
(928) 782-8056
Entity
Organization
Contact information
Practice address
2435 S AVE A STE A, YUMA, AZ 85364-7176
(928) 726-6772
Mailing address
2435 S AVE A, YUMA, AZ 85364-7175
(928) 726-6772
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42221
AZ
Other
Enumeration date
09/02/2009
Last updated
09/17/2009
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