Provider Demographics
NPI:1124321831
Name:PRIZIGLEY, ANDREW VALERYEVICH (PA-C)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:VALERYEVICH
Last Name:PRIZIGLEY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 WEAVER BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9804
Mailing Address - Country:US
Mailing Address - Phone:828-645-5088
Mailing Address - Fax:828-645-6095
Practice Address - Street 1:61 WEAVER BLVD STE 105
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-9804
Practice Address - Country:US
Practice Address - Phone:288-645-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105809363AS0400X
NC0010-07209363A00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine