| Dr Andrea Slifer Loder, MD | |
|
965 S Bailey Ave Ste 2-4, South Haven, MI 49090-6743 | |
| (269) 639-2777 | |
| (269) 639-2776 |
| Full Name | Dr Andrea Slifer Loder |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 965 S Bailey Ave Ste 2-4, South Haven, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861477903 | NPI | - | NPPES |
| 379588800 | Medicaid | FL | |
| 28977 | Other | FL | BCBSFL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | ME70335 (Florida) | Secondary |
| 208000000X | Pediatrics | 4301116417 (Michigan) | Primary |
| Entity Name | Bronson South Haven Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174749170 PECOS PAC ID: 6204724834 Enrollment ID: O20040305001005 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Andrea Slifer Loder, MD 1005 Mar Walt Dr, Pediatric Department, Fort Walton Beach, FL 32547-6707 Ph: (850) 863-8203 | Dr Andrea Slifer Loder, MD 965 S Bailey Ave Ste 2-4, South Haven, MI 49090-6743 Ph: (269) 639-2777 |
Dr. Karen L Janson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 955 S Bailey Ave, Suite 2-1, South Haven, MI 49090 Phone: 269-639-2772 Fax: 269-639-2770 | |
Caleb H Springsteen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 965 S Bailey Ave, Suite 2-1, South Haven, MI 49090 Phone: 269-639-2772 |