Individual
DR. ANDREW T BRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13000 N MERIDIAN ST STE 101, CARMEL, IN 46032-1404
(317) 208-3813
(317) 208-3815
Mailing address
13000 N MERIDIAN ST STE 101, CARMEL, IN 46032-1404
(317) 208-3813
(317) 208-3815
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01065291A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000698538
ANTHEM PROVIDER NUMBER
IN
05
—
201009500
—
IN
Enumeration date
05/20/2008
Last updated
08/17/2022
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