Mccullough, Andrea
Mccullough, Andrea is an sole proprietor health care provider with primary practice located at 700 River Dr , Fort Bragg CA 95437-5403. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as her primary health care specialty. Mccullough, Andrea can be contacted via phone (707) 961-4655.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | A61951 | California |
Profile Details
| NPI number | 1366535890 |
|---|---|
| LBN Legal business name | Mccullough, Andrea |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jun 24th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366535890 | NPPES |
| California | MEDICAID | 00A619510 |
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