Physician Compare National (NPI:1649269952)

HEALTHCARE PROVIDER: ANDREW J CANDELORE DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1649269952
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8325111941
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080715000755
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CANDELORE
	Individual professional last name
Provider First Name	ANDREW
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1973
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	617 US ROUTE 1
	Group Practice or individual's line 1 address
City	SCARBOROUGH
	Group Practice or individual's city
State	ME
	Group Practice or individual's state
Zip Code	040749714
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	200019
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHERN MAINE HEALTH CARE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	200009
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MAINE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y