Individual
DR. ANDREW T DYSANGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 948-6953
(317) 944-1289
Mailing address
250 N SHADELAND AVE, SUITE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(317) 274-7936
(317) 274-1587
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01074041A
IN
207RI0200X
Infectious Disease Physician
Primary
01074041A
IN
390200000X
Student in an Organized Health Care Education/Training Program
000000000000000
—
Other
Enumeration date
08/22/2011
Last updated
07/14/2016
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