Provider Demographics
NPI:1467582775
Name:BLAND, ANDREW C (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:BLAND
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 1:1515 DELHI ST
Mailing Address - Street 2:STE 100
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6320
Mailing Address - Country:US
Mailing Address - Phone:563-557-9111
Mailing Address - Fax:
Practice Address - Street 1:1500 DELHI ST STE 2100
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6319
Practice Address - Country:US
Practice Address - Phone:563-557-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0016279207RN0300X
IL036101258207RN0300X
WI718207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036101258Medicaid
ILP00047010OtherRAILROAD MEDICARE
ILL99613Medicare PIN
IL036101258Medicaid