Provider Demographics
NPI:1306839428
Name:PROOS, ANDREW A (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:A
Last Name:PROOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:690 CANTON ST
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2321
Mailing Address - Country:US
Mailing Address - Phone:781-407-7713
Mailing Address - Fax:781-407-0998
Practice Address - Street 1:164 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2853
Practice Address - Country:US
Practice Address - Phone:401-793-4574
Practice Address - Fax:401-454-1321
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2008-11-07
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Provider Licenses
StateLicense IDTaxonomies
RIMD11925207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D99811Medicare UPIN