Provider Demographics
NPI:1467458562
Name:HUMMEL, ANDREW THEODORE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:THEODORE
Last Name:HUMMEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 UPPER LEWISBURG SALEM RD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-9655
Mailing Address - Country:US
Mailing Address - Phone:937-833-4200
Mailing Address - Fax:937-833-3444
Practice Address - Street 1:582 UPPER LEWISBURG SALEM RD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-9655
Practice Address - Country:US
Practice Address - Phone:937-833-4200
Practice Address - Fax:937-833-3444
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHD2182OtherHUMANA
OH0122816Medicaid
OH000000108890OtherANTHEM
OH000000253046OtherANTHEM
OH2160286OtherFIRST HEALTH
OH44-00634OtherUNITED HEALTH CARE
OH000000253046OtherANTHEM
OHD2182OtherHUMANA