Provider Demographics
NPI:1629011572
Name:CYKIERT, ANDREW (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:CYKIERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1862
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:20317 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1411
Practice Address - Country:US
Practice Address - Phone:248-615-0777
Practice Address - Fax:248-615-0779
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101010933207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4338791OtherAETNA
MIOH29992OtherBLUE CROSS BLUE SHIELD
MIP76128OtherBLUE CARE NETWORK
MI2957941Medicaid
MIC5231OtherMCARE
MI139939OtherCARE CHOICES
MI2957941Medicaid