Individual
ANDREW CARL JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
49 HARRY KEMP WAY, PROVINCETOWN, MA 02657-1618
(508) 487-9395
(508) 487-3285
Mailing address
PO BOX 598, HARWICH PORT, MA 02646-0598
(508) 905-2800
(508) 240-1244
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
234187
MA
208000000X
Pediatrics Physician
234187
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110078100A
—
MA
01
—
234187
MA MEDICAL LICENSE
MA
Enumeration date
12/29/2005
Last updated
07/21/2022
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