Provider Demographics
NPI:1407898968
Name:ANDRIAN, MIHAELA (MD)
Entity Type:Individual
Prefix:DR
First Name:MIHAELA
Middle Name:
Last Name:ANDRIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 WILLOW VALLEY LAKES DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-9665
Mailing Address - Country:US
Mailing Address - Phone:717-735-3133
Mailing Address - Fax:717-735-3136
Practice Address - Street 1:226 WILLOW VALLEY LAKES DR
Practice Address - Street 2:SUITE F
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584-9665
Practice Address - Country:US
Practice Address - Phone:717-735-3133
Practice Address - Fax:717-735-3136
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2007-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA160152Medicaid
PA160152Medicaid
PA112425Medicare PIN