Provider Demographics
NPI:1932322104
Name:MCANDREW, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:MCANDREW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:777 ALGOMA BLVD
Mailing Address - Street 2:RADFORD HALL
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-3534
Mailing Address - Country:US
Mailing Address - Phone:920-424-2424
Mailing Address - Fax:920-424-1769
Practice Address - Street 1:777 ALGOMA BLVD
Practice Address - Street 2:RADFORD HALL
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-3534
Practice Address - Country:US
Practice Address - Phone:920-424-2424
Practice Address - Fax:920-424-1769
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI14810-0202084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine