Provider Demographics
NPI:1659403152
Name:ANDREWS, PATRICIA J (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E IDAHO AVE
Mailing Address - Street 2:#17
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3257
Mailing Address - Country:US
Mailing Address - Phone:505-526-5525
Mailing Address - Fax:505-541-0498
Practice Address - Street 1:225 E IDAHO AVE
Practice Address - Street 2:#17
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3257
Practice Address - Country:US
Practice Address - Phone:505-526-5525
Practice Address - Fax:505-541-0498
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM85-3207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMB9667Medicaid
NM37713Medicaid
NMNM009528OtherBLUE CROSS BLUE SHIELD
NM37713Medicaid
NMB9667Medicaid