| Lourdes V Andaya Md Pc | |
|
7 Cameron Pl Grosse Pointe MI 48230-1912 | |
| (313) 832-2880 | |
| (313) 832-2880 |
| Full Name | Lourdes V Andaya Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7 Cameron Pl, Grosse Pointe, Michigan |
| Authorized Official Name and Position | Lourdes V Andaya (PRESIDENT) |
| Authorized Official Contact | 3138322880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lourdes V Andaya Md Pc 4160 John R St Suite 819 Detroit MI 48201-2020 Ph: (313) 832-2880 | Lourdes V Andaya Md Pc 7 Cameron Pl Grosse Pointe MI 48230-1912 Ph: (313) 832-2880 |
| NPI Number | 1720295280 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/23/2010 |
| Medicare PECOS PAC ID | 3072646041 |
|---|---|
| Medicare Enrollment ID | O20100728000891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720295280 | NPI | - | NPPES |
| 1783024-10 | Medicaid | MI | |
| OH23713 | Other | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 4301032565 (Michigan) | Primary |
| Provider Name | Lourdes V Andaya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831274786 PECOS PAC ID: 5698808665 Enrollment ID: I20100825000475 |
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