Provider Demographics
NPI:1427016443
Name:ANTOSZYK, ANDREW NICHOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:NICHOLAS
Last Name:ANTOSZYK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:704-838-8494
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3000
Practice Address - Fax:704-838-8494
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28615207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6871OtherPARTNERS
NC0841446OtherUNITED HEALTHCARE
SC20095440OtherSELECT HEALTH OF SC
NC4324369OtherAETNA
NC10481OtherKANAWHA
NC141002OtherCOVENTRY
NC1922OtherDOCTORS HEALTH PLAN
NC51704OtherMEDCOST
SC772907OtherWELLCARE
NC8911627Medicaid
NC100703OtherWELLNESS
SCN28615Medicaid
NC0382669002OtherCIGNA
NC10590OtherWELLPATH
NC276584OtherMAMSI
NC10413OtherBCBS/MEDPOINT
NC11627OtherBCBS
VA6301533Medicaid
NC11627OtherBCBS
C82623Medicare UPIN
VA6301533Medicaid
NC276584OtherMAMSI