Phan, Andrew

Phan, Andrew is an individual health care provider with primary practice located at 331 Veranda St , Portland ME 04103-5545. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Phan, Andrew can be contacted via phone (207) 828-2402.

Contact Information

Primary practice address
331 Veranda St Portland ME 04103-5545
Phone: (207) 828-2402
Fax: (207) 828-2425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD16339 Maine
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD16339 Maine

Profile Details

NPI number 1619918307
LBN Legal business name Phan, Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Oct 14th, 2021 - about 4 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 1619918307 NPPES
Maine MEDICAID 417270099

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