Provider Demographics
NPI:1750328159
Name:ANDREW WARREN SAXE
Entity Type:Organization
Organization Name:ANDREW WARREN SAXE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:SAXE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-342-5519
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:ATTN: CRYSTAL BERESFORD
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1541
Mailing Address - Fax:810-342-1591
Practice Address - Street 1:3200 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-4968
Practice Address - Country:US
Practice Address - Phone:810-342-5519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301029389208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4872084Medicaid
MI0202512321OtherCOMMUNITY BLUE
MI0202512321OtherBLUE CHOICE
MI1019226OtherHEALTH ADVANTAGE
MI0202512321OtherBLUE CROSS BLUE SHIELD OF
MI1019226OtherMCLAREN HEALTH PLAN
MIA35251Medicare UPIN
MI0202512321OtherBLUE CHOICE