Provider Demographics
NPI:1831132653
Name:HUNDLEY, ANDREW F (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:F
Last Name:HUNDLEY
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 1:4775 KNIGHTSBRIDGE BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-4313
Mailing Address - Country:US
Mailing Address - Phone:614-442-2200
Mailing Address - Fax:614-442-1024
Practice Address - Street 1:4775 KNIGHTSBRIDGE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-4313
Practice Address - Country:US
Practice Address - Phone:614-442-2200
Practice Address - Fax:614-442-1024
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086737207VG0400X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2601214Medicaid
OH2601214Medicaid
OHHU4169192Medicare PIN