Provider Demographics
NPI:1396712659
Name:ALDRIDGE, ANDREW M (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:ALDRIDGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:29 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3238
Mailing Address - Country:US
Mailing Address - Phone:617-460-3611
Mailing Address - Fax:781-395-4571
Practice Address - Street 1:92 HIGH ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155
Practice Address - Country:US
Practice Address - Phone:617-460-3611
Practice Address - Fax:781-395-4571
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2018-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAMA767592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F45520Medicare UPIN