Provider Demographics
NPI:1396776944
Name:DANNEMANN, ANDREW F (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:F
Last Name:DANNEMANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1909 HONEYSUCKLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-4289
Mailing Address - Country:US
Mailing Address - Phone:334-699-7100
Mailing Address - Fax:334-699-7410
Practice Address - Street 1:1909 HONEYSUCKLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-4289
Practice Address - Country:US
Practice Address - Phone:334-699-7100
Practice Address - Fax:334-699-7410
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2012-10-08
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Provider Licenses
StateLicense IDTaxonomies
AL00016679207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B07451Medicare UPIN