Individual
R ANDREW PACKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 12TH ST STE 205, KEY WEST, FL 33040-3001
(305) 294-3458
(305) 294-8432
Mailing address
155 KEY HAVEN RD, KEY WEST, FL 33040-6212
(845) 532-8687
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME132264
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C04536
MEDICARE GROUP NUMBER
MS
Enumeration date
03/23/2006
Last updated
08/15/2019
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