Provider Demographics
NPI:1508831140
Name:JOHNSTONE, ANDREW A (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:A
Last Name:JOHNSTONE
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 1:3711 E SOUTHPORT RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-7874
Mailing Address - Country:US
Mailing Address - Phone:317-884-3725
Mailing Address - Fax:317-533-5660
Practice Address - Street 1:3711 E SOUTHPORT RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-7874
Practice Address - Country:US
Practice Address - Phone:317-884-3725
Practice Address - Fax:317-533-5660
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035232A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN132440GMedicare ID - Type Unspecified
ININ1725001Medicare PIN
INE05257Medicare UPIN
IN080132419OtherRAILROAD MEDICARE
INE05257Medicare UPIN