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General NPI Number Information
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NPI Number | 1124252374
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Entity Type | Individual
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Provider Name | JOHN STEVEN ANDRACHUK MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2009
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 1110 W PEACHTREE ST NW STE 950
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City | ATLANTA
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State | GA
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Zip | 30309-3609
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Country | US
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Telephone | 404-847-4210
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Fax | 404-847-4211
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Provider Business Mailing Address
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Address Line | 1110 W PEACHTREE ST NW STE 950
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City | ATLANTA
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State | GA
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Zip | 30309-3609
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Country | US
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Telephone | 404-847-4210
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Fax | 404-847-4211
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 069532
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License Number State | GA
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