Provider Demographics
NPI:1952373615
Name:POPYKIN, ANDREY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREY
Middle Name:
Last Name:POPYKIN
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 1:790 CHURCH ST NE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7282
Mailing Address - Country:US
Mailing Address - Phone:678-797-8201
Mailing Address - Fax:678-797-8259
Practice Address - Street 1:790 CHURCH ST NE
Practice Address - Street 2:SUITE 250
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7282
Practice Address - Country:US
Practice Address - Phone:678-797-8201
Practice Address - Fax:678-797-8259
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051715207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00240611OtherRAILROAD MEDICARE
GA320126OtherWELLCARE
GA000960385AMedicaid
GA000960385AMedicaid
GA11SCFJPMedicare ID - Type Unspecified