Healthcare Provider Details

I. General information

NPI: 1487755773
Provider Name (Legal Business Name): ROBERT LOUIS ANDRAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9611 PLAIN CITY GEORGESVILLE RD NE
PLAIN CITY OH
43064-8054
US

IV. Provider business mailing address

9611 PLAIN CITY GEORGESVILLE RD NE
PLAIN CITY OH
43064-8054
US

V. Phone/Fax

Practice location:
  • Phone: 614-873-5595
  • Fax:
Mailing address:
  • Phone: 614-873-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37448
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01062413A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number21947
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.037448
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0278551
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: