Individual
DR. ANDRE LEVESTER MCCOLLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4455 EDISON LAKES PKWY, MISHAWAKA, IN 46545-1414
(574) 231-6134
(574) 231-6845
Mailing address
623 MACON ST, APT 3, BROOKLYN, NY 11233-1515
(646) 251-8679
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01078115A
IN
207R00000X
Internal Medicine Physician
Primary
281409
NY
Other
Enumeration date
08/09/2012
Last updated
10/10/2019
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