Individual
MARK R MCANDREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
368 BIELBY RD, SUITE 100, LAWRENCEBURG, IN 47025-2774
(812) 537-5772
(812) 537-3936
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01050466A
IN
208600000X
Surgery Physician
35076656M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000065468
ANTHEM
—
01
—
116307
ANTHEM MEDICAID MCO
IN
01
—
1512442001
CIGNA
—
01
—
1701603
UNITED HEALTHCARE
—
05
—
200228410
—
IN
01
—
2180111
AETNA
—
01
—
N50466
HUMANA CHOICECARE
—
Enumeration date
08/02/2005
Last updated
11/05/2020
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