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General NPI Number Information
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NPI Number | 1134461460
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Entity Type | Individual
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Provider Name | ANDREA RACHEL WALDMAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 250 FOUNTAIN CT
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City | LEXINGTON
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State | KY
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Zip | 40509-1888
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Country | US
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Telephone | 859-263-4444
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Fax | 859-263-6781
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Provider Business Mailing Address
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Address Line | 1221 S BROADWAY
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City | LEXINGTON
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State | KY
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Zip | 40504-2701
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Country | US
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Telephone | 859-258-6200
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Fax | 859-258-5202
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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 | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | 58021
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 58021
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 303067
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License Number State | NY
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