Healthcare Provider Details
I. General information
NPI: 1902990435
Provider Name (Legal Business Name): ANDREA BERTRAM MCKEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2006
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
LAHEY CLINIC 41 MALL ROAD
BURLINGTON MA
01805-0001
US
IV. Provider business mailing address
5 MERRILL ST
AMESBURY MA
01913-4306
US
V. Phone/Fax
- Phone: 603-663-1800
- Fax: 603-668-4303
- Phone: 978-388-6618
- Fax: 978-388-5528
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 11200 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: