Provider Demographics
NPI:1851355705
Name:HORPENIUK, ANDREW DEMETRIUS (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DEMETRIUS
Last Name:HORPENIUK
Suffix:
Gender:M
Credentials:MD, MPH
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:324 FIREWEED CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-8635
Mailing Address - Country:US
Mailing Address - Phone:707-838-3370
Mailing Address - Fax:707-836-0860
Practice Address - Street 1:10 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-9554
Practice Address - Country:US
Practice Address - Phone:707-963-6491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG270672083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43205Medicare UPIN