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General NPI Number Information
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NPI Number | 1619149838
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Entity Type | Organization
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Legal Business Name | PAUL B ANDELIN MD PC
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 1937 W CARDINAL LN
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City | AURORA
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State | MO
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Zip | 65605-1977
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Country | US
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Telephone | 417-678-4022
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Fax | 417-678-4028
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Provider Business Mailing Address
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Address Line | 1937 W CARDINAL LN
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City | AURORA
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State | MO
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Zip | 65605-1977
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Country | US
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Telephone | 417-678-4022
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Fax | 417-678-4028
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL B ANDELIN
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Credential | M.D.
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Telephone | 417-678-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | R3M76
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | R3M76
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License Number State | MO
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