MEDICARE: MATTHEW ANDREW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1588511885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW ANDREW

Provider Business Mailing Address
First Line	:	4485 MOBILE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5865 W UTOPIA RD
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-5251
Country	:	US
Telephone Number	:	623-537-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/14/2026

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Directions to “ MATTHEW ANDREW ” Practice Location

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