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General NPI Number Information
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NPI Number | 1720295280
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Entity Type | Organization
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Legal Business Name | LOURDES V ANDAYA MD PC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 7 CAMERON PL
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City | GROSSE POINTE
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State | MI
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Zip | 48230-1912
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Country | US
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Telephone | 313-832-2880
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Fax | 313-832-2880
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Provider Business Mailing Address
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Address Line | 4160 JOHN R ST SUITE 819
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City | DETROIT
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State | MI
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Zip | 48201-2020
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Country | US
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Telephone | 313-832-2880
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Fax | 313-832-7845
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOURDES V ANDAYA
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Credential | MD
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Telephone | 313-832-2880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 4301032565
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License Number State | MI
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