Provider Demographics
NPI:1922318732
Name:HOSMAN, ANDREW E (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:E
Last Name:HOSMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13643 N THOMPSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:IL
Mailing Address - Zip Code:62860-1184
Mailing Address - Country:US
Mailing Address - Phone:618-435-9447
Mailing Address - Fax:
Practice Address - Street 1:13643 N THOMPSONVILLE RD
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:IL
Practice Address - Zip Code:62860-1184
Practice Address - Country:US
Practice Address - Phone:618-435-9447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085003890363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical