Provider Demographics
NPI:1427041904
Name:SMITH, ANDREW H (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:H
Last Name:SMITH
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 1:130 NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-775-8282
Mailing Address - Fax:508-775-1414
Practice Address - Street 1:130 NORTH STREET
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-775-8282
Practice Address - Fax:508-775-1414
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221560207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA18638OtherPILGRIM CIGNA
469686OtherTUFTS
MA9773983Medicaid
MA2080834Medicaid
2225900OtherFIRST HEALTH
MAAA18638OtherHARVARD PILGRIM HEALTH CARE
MAM15397OtherMA BLUE CROSS BLUE SHIELD
MAP00293039OtherRAILROAD MEDICARE PALMETTO GBA
J27894OtherBCBS
M15397OtherGROUP NUMBER
2225900OtherFIRST HEALTH
H51785Medicare UPIN