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General NPI Number Information
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NPI Number | 1194212951
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Entity Type | Individual
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Provider Name | ANDREW HA D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 165 BLUE RIDGE OVERLOOK
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City | BLUE RIDGE
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State | GA
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Zip | 30513-4431
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Country | US
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Telephone | 706-946-4647
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Fax | 706-374-0065
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Provider Business Mailing Address
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Address Line | 165 BLUE RIDGE OVERLOOK
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City | BLUE RIDGE
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State | GA
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Zip | 30513-4431
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Country | US
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Telephone | 706-946-5607
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Fax | 706-374-7628
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 309583
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | POD305018
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License Number State | GA
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