Provider Demographics
NPI:1770727679
Name:MARTHA G. ANDREWS
Entity type:Organization
Organization Name:MARTHA G. ANDREWS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:207-324-8483
Mailing Address - Street 1:312 COTTAGE ST STE E
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-1817
Mailing Address - Country:US
Mailing Address - Phone:207-324-8483
Mailing Address - Fax:207-490-5558
Practice Address - Street 1:312 COTTAGE ST STE E
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-1817
Practice Address - Country:US
Practice Address - Phone:207-324-8483
Practice Address - Fax:207-490-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
100443800OtherDEPT OF LABOR
ME128260000Medicaid
028853OtherANTHEM
MN2204OtherHARVARD PILGRIM
0905776OtherCIGNA
5932598OtherAETNA
ME128260000Medicaid