Provider Demographics
NPI:1962454850
Name:MCANDREW, JOHN ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ARTHUR
Last Name:MCANDREW
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2559 MEDICAL DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-8703
Mailing Address - Country:US
Mailing Address - Phone:575-434-2229
Mailing Address - Fax:575-439-5705
Practice Address - Street 1:2559 MEDICAL DR
Practice Address - Street 2:SUITE D
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-8703
Practice Address - Country:US
Practice Address - Phone:575-434-2229
Practice Address - Fax:575-439-5705
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY178447207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01684997Medicaid
NY01684997Medicaid
NYE47166Medicare UPIN