Provider Demographics
NPI:1669400818
Name:ECKER, ANDREW M (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:ECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 789967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:210 MALL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3260
Practice Address - Country:US
Practice Address - Phone:610-265-0726
Practice Address - Fax:610-265-3132
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD029085E207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0126626902OtherAMERICHOICE (UHC MA PLAN)
PA10926144OtherCAQH ID#
PA0019834OtherAETNA HMO
PA110236405OtherRRM
PA26575-MD029085EOtherHEALTH PARTNERS
PA1163449OtherCIGNA HMO/PPO
PA350698OtherPHCS
PA475021OtherHIGHMARK BLUE SHIELD
PA0047323000OtherIBC - PC/KHPE
PA1164942OtherKEYSTONE MERCY
PA0047323000OtherAMERIHEALTH/INTERCOUNTY
PA2122242OtherALLIANCE/OPT CHC (MAMSI)
PA0012662690004Medicaid
PA4110656OtherAETNA PPO
PA1163449OtherCIGNA HMO/PPO
PA1164942OtherKEYSTONE MERCY