Provider Demographics
NPI:1689600454
Name:NADEAU, ANDRE R (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:R
Last Name:NADEAU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HEALTH DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-0240
Mailing Address - Country:US
Mailing Address - Phone:207-623-0720
Mailing Address - Fax:207-623-0724
Practice Address - Street 1:3 HEALTH DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-0240
Practice Address - Country:US
Practice Address - Phone:207-623-0720
Practice Address - Fax:207-623-0724
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR834111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMNT860OtherHARVARD PILGRIM
ME025889OtherANTHEM
ME010529023OtherMEDNET
ME010529023OtherCBA/EBPA
ME204690099Medicaid
MEM166600OtherCIGNA
MEU54740Medicare UPIN
ME010529023OtherMEDNET