MEDICARE: ANDREW THOMAS THORNTON MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	74834	MN
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1043878713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW THOMAS THORNTON MD, MPH

Provider Business Mailing Address
First Line	:	303 E NICOLLET BLVD STE 100
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-4588
Country	:	US
Telephone Number	:	952-460-4071
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 E NICOLLET BLVD STE 100
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-4588
Country	:	US
Telephone Number	:	952-460-4071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2019
Last Update Date	:	07/19/2023

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