Provider Demographics
NPI:1467778241
Name:SENTER, ANDREA STALLSMITH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:STALLSMITH
Last Name:SENTER
Suffix:
Gender:F
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:DUKE RALEIGH HOSPITAL RADIOLOGY
Mailing Address - Street 2:3400 WAKE FOREST RD
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609
Mailing Address - Country:US
Mailing Address - Phone:919-954-3624
Mailing Address - Fax:410-354-0186
Practice Address - Street 1:3400 WAKE FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7317
Practice Address - Country:US
Practice Address - Phone:919-954-3624
Practice Address - Fax:410-354-0186
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2023-06-29
Deactivation Date:2021-07-15
Deactivation Code:
Reactivation Date:2021-07-16
Provider Licenses
StateLicense IDTaxonomies
NC2021-002552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology