Provider Demographics
NPI:1235341702
Name:MOORHEAD, ANDREW (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MOORHEAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 MACARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5410
Mailing Address - Country:US
Mailing Address - Phone:336-629-1000
Mailing Address - Fax:336-629-1300
Practice Address - Street 1:149 MACARTHUR ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5410
Practice Address - Country:US
Practice Address - Phone:336-629-1000
Practice Address - Fax:336-629-1300
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01448208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery