Provider Demographics
NPI:1255303145
Name:ANDRAWIS, AMIR A (MD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:A
Last Name:ANDRAWIS
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 1:4545 SERGEANT RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4706
Mailing Address - Country:US
Mailing Address - Phone:712-274-2700
Mailing Address - Fax:712-274-1487
Practice Address - Street 1:4545 SERGEANT RD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4706
Practice Address - Country:US
Practice Address - Phone:712-274-2700
Practice Address - Fax:712-274-1487
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33970207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G72940Medicare UPIN