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:
Health care specialties
| Specialty | Code | License # | 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 5 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 | 1619918307 | NPPES |
| Maine | MEDICAID | 417270099 |
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