Individual
DR. ADELBERT EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2281 W 24TH ST, YUMA, AZ 85364-6154
(928) 726-6772
Mailing address
PO BOX 5147, YUMA, AZ 85366-2458
(928) 726-6772
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42221
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2706708385
EIN
—
Enumeration date
06/07/2006
Last updated
01/13/2018
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