Provider Demographics
NPI:1831346733
Name:KING, ANDREW MARSHALL (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MARSHALL
Last Name:KING
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 1:230 MCKEE PL STE 500
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3903
Mailing Address - Country:US
Mailing Address - Phone:412-647-8283
Mailing Address - Fax:
Practice Address - Street 1:TOLAN PARK
Practice Address - Street 2:3901 CHRYSLER DR, SUITE 1A
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-4820
Practice Address - Country:US
Practice Address - Phone:313-577-1396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441036207P00000X
MI43011023232083A0300X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA202821LQVMedicare PIN