Individual
MARK CHARLES ANDREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 S HUNTINGTON AVE, BOSTON, MA 02130-4817
(857) 364-5795
Mailing address
21 BAY STATE RD UNIT 1, BOSTON, MA 02215-2101
(612) 619-6824
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA6230
MA
363AS0400X
Surgical Physician Assistant
Primary
PA6230
MA
Other
Enumeration date
08/18/2017
Last updated
04/17/2023
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