Provider Demographics
NPI:1023219276
Name:BABCOCK, ANDREW CARL (MD)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CARL
Last Name:BABCOCK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4414 LAKE BOONE TRL STE 502
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7521
Mailing Address - Country:US
Mailing Address - Phone:919-875-0539
Mailing Address - Fax:919-875-1051
Practice Address - Street 1:590 MANNING DR
Practice Address - Street 2:CB 7586
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7586
Practice Address - Country:US
Practice Address - Phone:919-966-0210
Practice Address - Fax:919-966-6126
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2016-06-16
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Provider Licenses
StateLicense IDTaxonomies
NC2009-01957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC76211UMedicare UPIN