Provider Demographics
NPI:1841440112
Name:PEARSON, ANDREA L (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:L
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LEAD MINE RD
Mailing Address - Street 2:
Mailing Address - City:NELSON
Mailing Address - State:NH
Mailing Address - Zip Code:03457-5342
Mailing Address - Country:US
Mailing Address - Phone:314-888-5233
Mailing Address - Fax:
Practice Address - Street 1:1 LEAD MINE RD
Practice Address - Street 2:
Practice Address - City:NELSON
Practice Address - State:NH
Practice Address - Zip Code:03457-5342
Practice Address - Country:US
Practice Address - Phone:314-888-5233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16322207R00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1020787Medicaid
NH3090874Medicaid