| Andrew J Mandery MD LLC | |
|
1948 W Boulevard Kokomo IN 46902-6078 | |
| (765) 236-1290 | |
| (765) 236-0420 |
| Full Name | Andrew J Mandery MD LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 1948 W Boulevard, Kokomo, Indiana |
| Authorized Official Name and Position | Andrew Jay Mandery (OWNER) |
| Authorized Official Contact | 7652361290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew J Mandery MD LLC 1948 W Boulevard Kokomo IN 46902-6078 Ph: (765) 236-1290 | Andrew J Mandery MD LLC 1948 W Boulevard Kokomo IN 46902-6078 Ph: (765) 236-1290 |
| NPI Number | 1922294115 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 09/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922294115 | NPI | - | NPPES |
| 148380 | Other | MEDICARE PROVIDER NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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