Healthcare Provider Details

I. General information

NPI: 1548227812
Provider Name (Legal Business Name): ANDREW L ASWEGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST
DOVER DE
19901-3530
US

IV. Provider business mailing address

PO BOX 758900
BALTIMORE MD
21275-8900
US

V. Phone/Fax

Practice location:
  • Phone: 410-398-4000
  • Fax:
Mailing address:
  • Phone: 866-916-5259
  • Fax: 231-922-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0062887
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: