Provider Demographics
NPI:1023181005
Name:GUERTLER, ANDREW THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:THOMAS
Last Name:GUERTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 SOUTH MASON ST, MSC 7901
Mailing Address - Street 2:JAMES MADISON UNIVERSITY HEALTH CENTER
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22807
Mailing Address - Country:US
Mailing Address - Phone:540-568-6178
Mailing Address - Fax:540-568-6176
Practice Address - Street 1:724 SOUTH MASON STREET MSC 7901 JMU HEALTH CENTER
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807-0001
Practice Address - Country:US
Practice Address - Phone:540-568-6178
Practice Address - Fax:540-568-6176
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040646207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA013283S22Medicare PIN
VAGC1100Medicare PIN