Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 1738021205 | UT |
NPI | 1356362875 |
---|---|
Provider Name | Robert L Andres |
First Address | Ogden, UT 84403-0128 |
Second Address | Ogden, UT 84403-3195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 16/10/2021 |