Healthcare Provider Details

I. General information

NPI: 1578791240
Provider Name (Legal Business Name): ANDREW THOMAS ASSENMACHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N MONROE ST
MONROE MI
48162-4211
US

IV. Provider business mailing address

1420 N MONROE ST
MONROE MI
48162-4211
US

V. Phone/Fax

Practice location:
  • Phone: 734-240-8480
  • Fax: 734-384-0469
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301095012
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35.129521
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number4301095012
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number35.129521
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: