Provider Demographics
NPI:1669461356
Name:ARCHER, ANDREA L (DO)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:ARCHER
Suffix:
Gender:F
Credentials:DO
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Other - First Name:
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Mailing Address - Street 1:38935 ANN ARBOR RD
Mailing Address - Street 2:CREDENTIALING DEPT.
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3397
Mailing Address - Country:US
Mailing Address - Phone:800-465-6052
Mailing Address - Fax:301-921-7915
Practice Address - Street 1:13710 ST FRANCIS BLVD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3267
Practice Address - Country:US
Practice Address - Phone:804-594-7950
Practice Address - Fax:804-594-7955
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2013-12-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102201422207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine