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General NPI Number Information
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NPI Number | 1811100688
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Entity Type | Individual
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Provider Name | ERIC ANDREAE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3010 HAMPTON AVE SUITE 6
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City | BRUNSWICK
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State | GA
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Zip | 31520-4224
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Country | US
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Telephone | 912-466-8909
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Fax |
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Provider Business Mailing Address
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Address Line | 415 COTTAGE EMERGENCY # 259 WEST 29TH ST.
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City | SEA ISLAND
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State | GA
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Zip | 31561
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Country | US
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Telephone | 912-466-8909
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 027340
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License Number State | GA
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