Provider Demographics
NPI:1811535966
Name:LUGERT, ANDREW ANTHONY (CAA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:ANTHONY
Last Name:LUGERT
Suffix:
Gender:M
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4048 S ATCHISON WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4138
Mailing Address - Country:US
Mailing Address - Phone:303-909-3857
Mailing Address - Fax:
Practice Address - Street 1:339 CONSORT DR
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-4439
Practice Address - Country:US
Practice Address - Phone:636-386-9224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32697532367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant