Provider Demographics
NPI:1790986651
Name:JOPPERI, ANDREA ALISON (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ALISON
Last Name:JOPPERI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:ALISON
Other - Last Name:ERB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:388 S MAIN ST
Mailing Address - Street 2:STE. 201
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1064
Mailing Address - Country:US
Mailing Address - Phone:330-773-7866
Mailing Address - Fax:330-773-5090
Practice Address - Street 1:388 S MAIN ST
Practice Address - Street 2:STE. 201
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1064
Practice Address - Country:US
Practice Address - Phone:330-773-7866
Practice Address - Fax:330-773-5090
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34009156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2877589Medicaid
4239802OtherMEDICARE ID