Provider Demographics
NPI:1861480337
Name:NARCELLES, ANDREW M
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:NARCELLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 FRANTZ RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4134
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7340 E BROAD ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-9625
Practice Address - Country:US
Practice Address - Phone:614-566-7300
Practice Address - Fax:614-544-7315
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2323293Medicaid
OHNA4084481Medicare PIN