Provider Demographics
NPI:1720023146
Name:WININGER, ANDREA NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:WININGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330C PELHAM RD STE A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3111
Mailing Address - Country:US
Mailing Address - Phone:864-720-1299
Mailing Address - Fax:864-720-1300
Practice Address - Street 1:330C PELHAM RD STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3111
Practice Address - Country:US
Practice Address - Phone:864-720-1299
Practice Address - Fax:864-720-1300
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24619207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA10467111OtherMEDICARE PTAN
SC246193Medicaid
SC7111Medicare PIN
SCAA60657951Medicare PIN
SCI39577Medicare UPIN