Basic Information
| Provider Information | |||||||||
| NPI: | 1447230438 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMAYS | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | EDWARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5128 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253610128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044242111 | ||||||||
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| Practice Location | |||||||||
| Address1: | 209 WEST 27TH STREET | ||||||||
| Address2: | |||||||||
| City: | LUMBERTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283583016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107388222 | ||||||||
| FaxNumber: | 9106710846 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 08/27/2019 | ||||||||
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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 | 2085R0202X | 01051741A | IN | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 29056 | WV | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 2006-01546 | NC | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 5905234 | 05 | NC | MEDICAID | 143XJ | 01 | NC | BLUE CROSS BLUE SHIELD | OTHER |