Provider Demographics
NPI:1275599748
Name:FILAK, ANDREW T (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:T
Last Name:FILAK
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:PO BOX 636256
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-585-5501
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:3120 BURNET AVE STE 406
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3022
Practice Address - Country:US
Practice Address - Phone:513-584-8600
Practice Address - Fax:513-584-8620
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043551F207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64785280Medicaid
OH0464304Medicaid
IN100385430Medicaid
KY64785280Medicaid
OH080151754Medicare PIN
OHFI0473798Medicare PIN