Individual
RAUL RENE ANDINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
505 N JACKSON ST, JACKSON, MI 49201-1266
(517) 748-5500
(517) 780-9286
Mailing address
505 N JACKSON ST, JACKSON, MI 49201-1266
(517) 748-5500
(517) 780-9286
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
10941
PR
207V00000X
Obstetrics & Gynecology Physician
Primary
4301085215
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200018350A
—
OK
Enumeration date
08/12/2006
Last updated
08/24/2020
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