Provider Demographics
NPI:1811947294
Name:YOUNG, ANDREW N (MD, PHD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:N
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 JESSE HILL JR. DR.
Mailing Address - Street 2:GRADY MEMORIAL HOSPITAL
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-616-4800
Mailing Address - Fax:404-616-9913
Practice Address - Street 1:80 JESSE HILL JR. DR.
Practice Address - Street 2:GRADY MEMORIAL HOSPITAL
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-616-4800
Practice Address - Fax:404-616-9913
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042149207ZH0000X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Not Answered207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA042149OtherMEDICAL LICENSE