Provider Demographics
NPI:1003817594
Name:SCROGIN, ANDREW DEAN (M D)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DEAN
Last Name:SCROGIN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR LBBY J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:1854 W AUBURN RD STE 100A
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3868
Practice Address - Country:US
Practice Address - Phone:248-696-3170
Practice Address - Fax:248-696-3175
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073359207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1102803611OtherBLUE CROSS BLUE SHIELD
MI1102803611OtherBLUE CROSS BLUE SHIELD
MI0N93630Medicare ID - Type Unspecified