Provider Demographics
NPI:1518229459
Name:TUFO, ANDREA K (DO)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:TUFO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1234 E DUPONT RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1545
Mailing Address - Country:US
Mailing Address - Phone:260-373-7854
Mailing Address - Fax:260-458-5664
Practice Address - Street 1:309 INSURANCE DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-4252
Practice Address - Country:US
Practice Address - Phone:175-592-1853
Practice Address - Fax:883-673-0254
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2021-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN02004309A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201090320Medicaid