Provider Demographics
NPI:1669465084
Name:ANDREWS, DAVID MARTIN (OD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MARTIN
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2138 W PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4048
Mailing Address - Country:US
Mailing Address - Phone:843-662-1989
Mailing Address - Fax:843-667-8897
Practice Address - Street 1:2138 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4048
Practice Address - Country:US
Practice Address - Phone:843-662-1989
Practice Address - Fax:843-667-8897
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC607152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC469037002OtherDMERC
SCDA9740Medicaid
SCD07720Medicaid
SCDP2037OtherMEDICARE RAILROAD
SCDA9978Medicaid
SCT248358081Medicare PIN
SCDA9740Medicaid
SCDA9978Medicaid