Provider Demographics
NPI:1710976410
Name:RICH, ANDREW A (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:A
Last Name:RICH
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 1:800 HOSPITAL DR.
Mailing Address - Street 2:HARRY S. TRUMAN MEMORIAL VETERANS HOSPITAL
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201
Mailing Address - Country:US
Mailing Address - Phone:573-814-6565
Mailing Address - Fax:573-814-6331
Practice Address - Street 1:800 HOSPITAL DR.
Practice Address - Street 2:HARRY S. TRUMAN MEMORIAL VETERANS HOSPITAL
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201
Practice Address - Country:US
Practice Address - Phone:573-814-6565
Practice Address - Fax:573-814-6331
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST00470208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSX15E460OtherMEDICARE
KS200373140BMedicaid
KST00470OtherKANSAS STATE LICENSE
KS200373140AMedicaid
KS200373140AMedicaid
KSA52978Medicare UPIN