Individual
DR. ANDREW SANFORD KOIVUNIEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D./PH.D.
Contact information
Practice address
3001 S CREASY LN STE 100A, LAFAYETTE, IN 47905-5206
(765) 701-6451
(765) 420-5801
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01088594A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11018180A
PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
06/16/2015
Last updated
10/09/2023
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