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General NPI Number Information
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NPI Number | 1124346325
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Entity Type | Individual
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Provider Name | ANDREA MIKOL HEUSER MD
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Gender | Female
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 01/29/2019
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Provider Practice Location Address
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Address Line | 4750 WATERS AVE STE 206
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City | SAVANNAH
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State | GA
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Zip | 31404-6278
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Country | US
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Telephone | 912-350-5915
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Fax | 912-350-5930
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Provider Business Mailing Address
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Address Line | 4750 WATERS AVE STE 206
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City | SAVANNAH
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State | GA
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Zip | 31404-6278
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Country | US
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Telephone | 912-350-5915
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Fax | 912-350-5930
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 36347
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 80856
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License Number State | GA
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