Provider Demographics
NPI:1982691168
Name:STEMAR, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:STEMAR
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 1:7956 TYLER BLVD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4806
Mailing Address - Country:US
Mailing Address - Phone:440-255-4455
Mailing Address - Fax:440-255-3637
Practice Address - Street 1:17747 CHILLICOTHE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4739
Practice Address - Country:US
Practice Address - Phone:440-543-8855
Practice Address - Fax:440-543-2470
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070226207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000210552OtherANTHEM
OH0278382Medicaid
OH110130222Medicare PIN
0806303Medicare PIN
OH000000210552OtherANTHEM
OH0278382Medicaid
OH0806301Medicare PIN