Provider Demographics
NPI:1114121704
Name:THAMES-ALLEN, ANDREA JANEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:JANEL
Last Name:THAMES-ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 HIRAM DR
Mailing Address - Street 2:BLDG B
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-1844
Mailing Address - Country:US
Mailing Address - Phone:678-945-8300
Mailing Address - Fax:
Practice Address - Street 1:51 HIRAM DR
Practice Address - Street 2:BLDG B
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-1844
Practice Address - Country:US
Practice Address - Phone:678-945-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA062613208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics