Provider Demographics
NPI:1801165071
Name:ANDREW M. SAW, M.D., P.C.
Entity type:Organization
Organization Name:ANDREW M. SAW, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-237-2232
Mailing Address - Street 1:3003 CENTRAL AVE
Mailing Address - Street 2:P O BOX 1028
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-3506
Mailing Address - Country:US
Mailing Address - Phone:308-237-2232
Mailing Address - Fax:308-237-2376
Practice Address - Street 1:3003 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-3506
Practice Address - Country:US
Practice Address - Phone:308-237-2232
Practice Address - Fax:308-237-2376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-17
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18484204R00000X, 2084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NEC67728Medicare UPIN