Provider Demographics
NPI:1881624278
Name:ANDREWS, ANDREA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ELIZABETH
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1430 FIVE FORKS TRICKUM RD
Mailing Address - Street 2:SUITE 220 GEORGIA FAMILY CARE, LLC
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-8182
Mailing Address - Country:US
Mailing Address - Phone:678-578-4983
Mailing Address - Fax:678-578-4999
Practice Address - Street 1:1430 FIVE FORKS TRICKUM RD STE 220
Practice Address - Street 2:GEORGIA FAMILY CARE, LLC
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-8183
Practice Address - Country:US
Practice Address - Phone:678-205-4999
Practice Address - Fax:678-205-4969
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056954207Q00000X
AL29149207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA212066821HMedicaid
GA212066821AMedicaid
GA202I088442Medicare UPIN
GA08CBBJQMedicare ID - Type Unspecified
GA212066821HMedicaid