Provider Demographics
NPI:1639136039
Name:EISENHAUER, ANDREW CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CRAIG
Last Name:EISENHAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 HIGH ST
Mailing Address - Street 2:CENTRAL MAINE HEART ASSOCIATES
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7616
Mailing Address - Country:US
Mailing Address - Phone:207-753-3900
Mailing Address - Fax:207-753-3902
Practice Address - Street 1:60 HIGH ST
Practice Address - Street 2:CENTRAL MAINE HEART ASSOCIATES
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7616
Practice Address - Country:US
Practice Address - Phone:207-753-3900
Practice Address - Fax:207-753-3902
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20454207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE400194963Medicare PIN