Individual
ANDREW D. MANN
Active
Individual
ANDREW D. MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301055379
MI
2084P0800X
Psychiatry Physician
Primary
53911
MA
2084P0804X
Child & Adolescent Psychiatry Physician
4301055379
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258880110
—
MI
01
—
700H262290
BLUE CROSS-BLUE CROSS
—
01
—
AM055379
CHAMPUS-CHAMPUS
—
Enumeration date
12/15/2005
Last updated
07/14/2011
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