Individual
DR. ANDREW JONATHAN NIEWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 MEMORIAL MEDICAL PKWY STE 502, DAYTONA BEACH, FL 32117-5169
(386) 231-3570
(386) 231-3571
Mailing address
305 MEMORIAL MEDICAL PKWY STE 502, DAYTONA BEACH, FL 32117-5169
(386) 231-3570
(386) 231-3571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME114967
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206336307
—
MO
Enumeration date
04/02/2007
Last updated
01/31/2019
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