Provider Demographics
NPI:1588606982
Name:BOZOKI, ANDREA CATHRYN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:CATHRYN
Last Name:BOZOKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MANNING DRIVE CB 7025
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7025
Mailing Address - Country:US
Mailing Address - Phone:919-843-1220
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:194 FINLEY GOLF COURSE RD STE 200
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4403
Practice Address - Country:US
Practice Address - Phone:984-974-4401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010636512084B0040X
IN01083537A2084N0400X
NC2020-038402084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4299577Medicaid
MI1588606982Medicaid
MI1588606982Medicaid
MI4299577Medicaid