Provider Demographics
NPI:1639194244
Name:BONE, ANDREW P (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:P
Last Name:BONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3074 N US 31 S
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4533
Mailing Address - Country:US
Mailing Address - Phone:319-291-2342
Mailing Address - Fax:231-935-0984
Practice Address - Street 1:3074 N US 31 S
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4533
Practice Address - Country:US
Practice Address - Phone:231-929-1234
Practice Address - Fax:231-935-0984
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIAB057847207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF70274Medicare UPIN