Individual
ANDREW DUNDEE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1312 W. ARCH HAVEN AVENUE, SUITE A, BLOOMINGTON, IN 47403
(812) 676-4144
(812) 339-8344
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
(812) 353-3087
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01068273A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01068273A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200982140
—
IN
Enumeration date
08/31/2006
Last updated
12/04/2020
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