Provider Demographics
NPI:1982695912
Name:MIZERAK, ANDREW J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:MIZERAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1111 DUFF AVE, PO BOX 3014
Mailing Address - Street 2:MCFARLAND CLINIC, PC
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-3665
Mailing Address - Fax:519-239-3665
Practice Address - Street 1:1111 DUFF AVE
Practice Address - Street 2:MCFARLAND CLINIC, PC
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3014
Practice Address - Country:US
Practice Address - Phone:515-239-3665
Practice Address - Fax:515-239-3665
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA36005207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0459792Medicaid
IAH41432Medicare UPIN
IA0459792Medicaid