Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | MD425417 | PA |
NPI | 1295716298 |
---|---|
Provider Name | Gregory A Andrews |
First Address | Erie, PA 16505-8430 |
Second Address | Erie, PA 16506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 28/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G43995 | (02) | PA |