Provider Demographics
NPI:1932588803
Name:KING, ANDREW W (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:W
Last Name:KING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3409 THOMASVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-5438
Mailing Address - Country:US
Mailing Address - Phone:743-229-3300
Mailing Address - Fax:743-229-3324
Practice Address - Street 1:3409 THOMASVILLE RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-5438
Practice Address - Country:US
Practice Address - Phone:743-229-3300
Practice Address - Fax:743-229-3324
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOT016478207Q00000X
NC2018-02010207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine