Individual
ANDREW F ROUSH
Active
Individual
ANDREW F ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004512
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510962418A
—
GA
05
—
510962418K
—
GA
01
—
581177261A
MEDICARE GRP PROV #
GA
01
—
P00298024
RAILROAD MEDICARE
GA
Enumeration date
10/11/2006
Last updated
01/13/2021
Update your record
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