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General NPI Number Information
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NPI Number | 1255370409
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Entity Type | Individual
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Provider Name | MARK ADELMAN P.A.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7436 E MAIN ST STE 2
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City | MESA
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State | AZ
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Zip | 85207-8338
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Country | US
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Telephone | 480-983-5111
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Fax | 480-982-4686
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Provider Business Mailing Address
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Address Line | 2224 W CATALINA AVE
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City | MESA
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State | AZ
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Zip | 85202-2627
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Country | US
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Telephone | 480-898-1596
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Fax | 480-898-1596
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1501
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License Number State | AZ
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