Provider Demographics
NPI:1508470816
Name:LINDEMAN, ANDREW HOWARD
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:HOWARD
Last Name:LINDEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 E SUGAR MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR
Mailing Address - State:MI
Mailing Address - Zip Code:49621-9599
Mailing Address - Country:US
Mailing Address - Phone:231-715-6717
Mailing Address - Fax:
Practice Address - Street 1:2118 E SUGAR MAPLE DR
Practice Address - Street 2:
Practice Address - City:CEDAR
Practice Address - State:MI
Practice Address - Zip Code:49621-9599
Practice Address - Country:US
Practice Address - Phone:231-715-6717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer