Provider Demographics
NPI:1629229281
Name:GREENSPAN, ANDREW JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JEFFREY
Last Name:GREENSPAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5230 FIORE TER
Mailing Address - Street 2:107
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5648
Mailing Address - Country:US
Mailing Address - Phone:609-468-9854
Mailing Address - Fax:858-784-3013
Practice Address - Street 1:5230 FIORE TER
Practice Address - Street 2:107
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5648
Practice Address - Country:US
Practice Address - Phone:609-468-9854
Practice Address - Fax:858-784-3013
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA69050207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine