Basic Information
| Provider Information | |||||||||
| NPI: | 1396717468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLEWWELLING | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5525 RESEARCH PARK DR FL 4 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212284873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7815347100 | ||||||||
| FaxNumber: | 7815347358 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 LINDEN PONDS WAY | ||||||||
| Address2: | |||||||||
| City: | HINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020433769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7815347100 | ||||||||
| FaxNumber: | 7815347358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2006 | ||||||||
| LastUpdateDate: | 12/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 226799 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 04-61822 | 01 | EVERCARE | OTHER | 1396717468 | 01 | BCBS | OTHER | 2115000 | 05 | MA | MEDICAID | J29714 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 494561 | 01 | MA | TUFTS HEALTH PLAN | OTHER | AA52514 | 01 | MA | HARVARD PILGRIM | OTHER |