Healthcare Provider Details

I. General information

NPI: 1770727679
Provider Name (Legal Business Name): MARTHA G. ANDREWS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 01/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 COTTAGE ST STE E
SANFORD ME
04073-1817
US

IV. Provider business mailing address

312 COTTAGE ST STE E
SANFORD ME
04073-1817
US

V. Phone/Fax

Practice location:
  • Phone: 207-324-8483
  • Fax: 207-490-5558
Mailing address:
  • Phone: 207-324-8483
  • Fax: 207-490-5558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1
License Number StateME

VIII. Authorized Official

Name: MARTHA ANDREWS
Title or Position: AUDIOLOGIST
Credential: MA
Phone: 207-324-8483