Individual
ANDREW WILLIAM POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3707 NEW VISION DR, FORT WAYNE, IN 46845-1702
(260) 471-9466
Mailing address
116 EAGLE CLIFF CV, HUNTERTOWN, IN 46748-9288
(281) 753-6095
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01069990A
IN
2085R0202X
Diagnostic Radiology Physician
35.097940
OH
2085R0202X
Diagnostic Radiology Physician
M9583
TX
Other
Enumeration date
05/10/2008
Last updated
10/12/2011
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