Provider Demographics
NPI:1508828468
Name:ANDUZE, ALFRED LEE (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:LEE
Last Name:ANDUZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3019
Mailing Address - Street 2:
Mailing Address - City:KINGSHILL
Mailing Address - State:VI
Mailing Address - Zip Code:00851-3019
Mailing Address - Country:US
Mailing Address - Phone:340-773-2015
Mailing Address - Fax:340-719-9590
Practice Address - Street 1:4500 SUNNY ISLE ISLAND MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:CHRISITANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4493
Practice Address - Country:US
Practice Address - Phone:340-773-2015
Practice Address - Fax:340-719-9590
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI442207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI0062290AMedicare PIN
VIF04211Medicare UPIN