Provider Demographics
NPI:1467464909
Name:ANDREAS, DAVID BRIAN (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRIAN
Last Name:ANDREAS
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 1:505 SHOPPERS DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391
Mailing Address - Country:US
Mailing Address - Phone:859-744-1358
Mailing Address - Fax:859-744-3144
Practice Address - Street 1:505 SHOPPERS DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391
Practice Address - Country:US
Practice Address - Phone:859-744-1358
Practice Address - Fax:859-744-3144
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28192207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64281926Medicaid
F10187Medicare UPIN
KY64281926Medicaid