Provider Demographics
NPI:1437374667
Name:DYER, ANDREW WAKEFIELD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WAKEFIELD
Last Name:DYER
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 1:85 GREY OAKS DR
Mailing Address - Street 2:APT. 204
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-8925
Mailing Address - Country:US
Mailing Address - Phone:901-210-9654
Mailing Address - Fax:
Practice Address - Street 1:1661 INTERNATIONAL PLACE DRIVE
Practice Address - Street 2:SUITE 350
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120
Practice Address - Country:US
Practice Address - Phone:901-685-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN460842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology