Individual
DR. ANDREW DAVIS FANDIALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-7200
Mailing address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101024012
MI
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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