Provider Demographics
NPI:1710956164
Name:ANDREWS, RICHARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 NININGER RD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-1086
Mailing Address - Country:US
Mailing Address - Phone:651-480-4200
Mailing Address - Fax:651-480-4306
Practice Address - Street 1:2925 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1321
Practice Address - Country:US
Practice Address - Phone:612-262-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN22328207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN100052OtherUCARE MINNESOTA
WI30190600OtherMEDICAID WI
MN66-46829OtherMEDICA URGENT CARE
MNFP9702OtherAMERICA'S PPO
MNHP10034OtherHP10034
MN232888700Medicaid
MN080108728OtherRAILROAD MEDICARE
MN01-00070OtherMEDICA
MN4K541ANOtherBLUE CROSS
MNNA9141001148OtherPREFERRED ONE
MN080108728OtherRAILROAD MEDICARE
MNA93943Medicare UPIN