Healthcare Provider Details

I. General information

NPI: 1952339525
Provider Name (Legal Business Name): ANDREA MARIE LERCH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6011 E WOODMEN RD SUITE 320
COLORADO SPRINGS CO
80923-2602
US

IV. Provider business mailing address

6011 E WOODMEN RD SUITE 320
COLORADO SPRINGS CO
80923-2602
US

V. Phone/Fax

Practice location:
  • Phone: 719-591-6666
  • Fax: 719-573-0731
Mailing address:
  • Phone: 719-591-6666
  • Fax: 719-573-0731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number28516
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: