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Individual

ANDREW GEORGIADIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 291-2848
(651) 602-6885
Mailing address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 291-2848
(651) 602-6885

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301094549
MI
207X00000X
Orthopaedic Surgery Physician
Primary
59901
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
400266677
MEDICARE PTAN
MN
Enumeration date
06/23/2009
Last updated
06/07/2019
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