Individual
ANDREW J HAYDUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39000 BOB HOPE DR, KIEWIT SUITE 206, RANCHO MIRAGE, CA 92270-3221
(760) 341-6996
(760) 341-6776
Mailing address
39000 BOB HOPE DR, KIEWIT SUITE 206, RANCHO MIRAGE, CA 92270-3221
(760) 341-6996
(760) 341-6776
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A70532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A705320
BLUE SHIELD PROVIDER #
CA
Enumeration date
08/12/2005
Last updated
03/19/2008
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