Individual
ANDREW IRA LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1089 X RAY DR, GASTONIA, NC 28054-7489
(704) 864-8377
(704) 864-4442
Mailing address
1089 X RAY DR, GASTONIA, NC 28054-7489
(704) 864-8377
(704) 864-4442
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00-32756
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020021344
RR MEDICARE
NC
01
—
0642796-002
CIGNA
NC
01
—
11947
PARTNERS
NC
01
—
17-41296
UNITED HEALTH CARE
NC
01
—
2029703
AETNA/USHC HMO
NC
01
—
256269
MAMSI
NC
01
—
35390
MEDCOST
NC
01
—
4457934
AETNA/USHC
NC
01
—
51932
BCBS NC
NY
05
—
8951932
—
NC
Enumeration date
04/26/2006
Last updated
05/21/2009
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