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General NPI Number Information
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NPI Number | 1669785937
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Entity Type | Individual
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Provider Name | ANDREW PHILLIP SCHANNEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 2100 LOUISIANA BLVD NE STE 410
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-5412
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Country | US
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Telephone | 505-724-4300
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Fax | 505-338-0034
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Provider Business Mailing Address
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Address Line | 1248 N NORTON AVE
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City | TUCSON
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State | AZ
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Zip | 85719-4715
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Country | US
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Telephone | 802-310-1674
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Fax |
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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 | MD2016-0639
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License Number State | NM
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