Provider Demographics
NPI:1538135645
Name:ANDREI, ANCA ELENA (MD)
Entity Type:Individual
Prefix:
First Name:ANCA
Middle Name:ELENA
Last Name:ANDREI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22301 FOSTER WINTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3707
Mailing Address - Country:US
Mailing Address - Phone:248-552-0620
Mailing Address - Fax:248-552-0286
Practice Address - Street 1:22301 FOSTER WINTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3707
Practice Address - Country:US
Practice Address - Phone:248-552-0620
Practice Address - Fax:248-552-0286
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301083623207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4880101Medicaid
MI4880101Medicaid