Provider Demographics
NPI:1902843147
Name:MCANDREWS, MARTHA E (MD)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:E
Last Name:MCANDREWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14645 HAZEL DELL RD STE 120
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-7067
Practice Address - Country:US
Practice Address - Phone:317-922-2090
Practice Address - Fax:317-574-1875
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0102338207P00000X
IN01032338207Q00000X
IN01032338A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100342880Medicaid
IN100342880Medicaid