Provider Demographics
NPI:1598832990
Name:AVERBACH, ANDREW M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:M
Last Name:AVERBACH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:700 GEIPE RD
Mailing Address - Street 2:SUITE 274
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4147
Mailing Address - Country:US
Mailing Address - Phone:667-234-8725
Mailing Address - Fax:667-234-8726
Practice Address - Street 1:700 GEIPE RD
Practice Address - Street 2:SUITE 274
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4147
Practice Address - Country:US
Practice Address - Phone:667-234-8725
Practice Address - Fax:667-234-8726
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2018-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0056938208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401671800Medicaid
MD401671800Medicaid