Provider Demographics
NPI:1184184376
Name:WARREN, ANDREW PORTER (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PORTER
Last Name:WARREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1120 15TH ST # OR6000
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-721-0211
Mailing Address - Fax:706-721-9286
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-6511
Practice Address - Country:US
Practice Address - Phone:706-721-0211
Practice Address - Fax:706-721-9286
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA92024207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine