Provider Demographics
NPI:1558395079
Name:MCAFEE, ANDREW CLARK (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CLARK
Last Name:MCAFEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3245 HEALTH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-1380
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6913 N MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-8039
Practice Address - Country:US
Practice Address - Phone:574-647-1500
Practice Address - Fax:574-647-2567
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064116A207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200889300Medicaid
IN000000756241OtherBCBS BMG E BLAIR WARNER
IN941030A1OtherMEDICARE PTAN
IN200889300Medicaid
INP00788347OtherRR MEDICARE
IN000000611879OtherBCBS BMG MAIN STREET
KS000000646071OtherBCBS MEMORIAL WEIGHT LOSS & BARIATRIC
IN000000611289OtherBCBS MED POINT
INM400067609Medicare PIN
IN000000756241OtherBCBS BMG E BLAIR WARNER
IN236040I1Medicare PIN