Provider Demographics
NPI:1093894115
Name:ZACHARY, ANDREA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:A
Last Name:ZACHARY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 E MONUMENT ST
Mailing Address - Street 2:IMMUNOGENETICS LABORATORY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-2222
Mailing Address - Country:US
Mailing Address - Phone:410-614-8978
Mailing Address - Fax:410-955-0431
Practice Address - Street 1:2041 E MONUMENT ST
Practice Address - Street 2:IMMUNOGENETICS LABORATORY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-2222
Practice Address - Country:US
Practice Address - Phone:410-614-8978
Practice Address - Fax:410-955-0431
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist