Basic Information
| Provider Information | |||||||||
| NPI: | 1063791853 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | CHARLES RICHARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 340 THOMAS MORE PKWY STE 260 | ||||||||
| Address2: | |||||||||
| City: | CRESTVIEW HILLS | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410175117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8599570700 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 800 GARFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | PARKERSBURG | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261015340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044220405 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2011 | ||||||||
| LastUpdateDate: | 03/05/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 4301098454 | MI | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | A141041 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LC0200X | 4301098454 | MI | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207LC0200X | ME127711 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207LP2900X | 4301098454 | MI | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207RC0200X | R9912 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RC0200X | 29345 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207LP2900X | 53179 | KY | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.