Provider Demographics
NPI:1669565081
Name:APPELBAUM, ANDREW (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:APPELBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 COMMUNICATION AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-3308
Mailing Address - Country:US
Mailing Address - Phone:561-982-4300
Mailing Address - Fax:
Practice Address - Street 1:1370 116TH AVE NE STE 206
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3825
Practice Address - Country:US
Practice Address - Phone:425-378-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0134939OtherLABOR & INDUSTRIES NUMBER
WAAP1932OtherREGENCE RIDER NUBMER
WA8207433Medicaid
WAAB29527Medicare ID - Type UnspecifiedMEDICARE NUMBER
WA0134939OtherLABOR & INDUSTRIES NUMBER