Healthcare Provider Details

I. General information

NPI: 1124940010
Provider Name (Legal Business Name): ANDREW G MCINTYRE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 HIGHTOWER TRL
SANDY SPRINGS GA
30350-2923
US

IV. Provider business mailing address

5070 PEACHTREE BLVD UNIT 1322
CHAMBLEE GA
30341-2885
US

V. Phone/Fax

Practice location:
  • Phone: 770-234-0981
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAPRN-NP239294
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: