Provider Demographics
NPI:1063679330
Name:SO, ANDREW U (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:U
Last Name:SO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-9800
Mailing Address - Country:US
Mailing Address - Phone:570-271-6177
Mailing Address - Fax:570-271-8795
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-271-6177
Practice Address - Fax:570-271-8795
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOT011053207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease