Berdasono, Andrew

Berdasono, Andrew is an sole proprietor health care provider with primary practice located at 4201 Saint Antoine St , Detroit MI 48201-2153. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Berdasono, Andrew can be contacted via phone (952) 442-9770.

Contact Information

Primary practice address
4201 Saint Antoine St Detroit MI 48201-2153
Phone: (952) 442-9770
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704226663 Michigan

Profile Details

NPI number 1811974561
LBN Legal business name Berdasono, Andrew
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 23rd, 2005
Last updated Feb 1st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811974561 NPPES
Michigan MEDICAID 104749330
Michigan Other AB226663

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