Provider Demographics
NPI:1073594669
Name:MCGINNIS, ANDREW W (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:W
Last Name:MCGINNIS
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 1:1501 LANSDOWNE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1333
Mailing Address - Country:US
Mailing Address - Phone:610-534-6150
Mailing Address - Fax:
Practice Address - Street 1:1501 LANSDOWNE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1333
Practice Address - Country:US
Practice Address - Phone:610-534-6150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD01287E207RC0000X
NJ25MA02867700207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0031363000OtherIBC HMO
PAB35065Medicare UPIN
PA000076081Medicare PIN