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NPI Code Detail

MEDICARE: ANDREW LEWIS CECIL

MEDICARE:   ANDREW LEWIS CECIL
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1710732367
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW LEWIS CECIL
Provider Business Mailing Address
First Line : 945 N 12TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53233-1305
Country : US
Telephone Number : 414-219-7136
Fax Number : 414-219-6264
Provider Business Practice Location Address
First Line : PO BOX 342
Second Line :
City : MILWAUKEE
State : WI
Zip : 53201-0342
Country : US
Telephone Number : 414-219-7635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2024
Last Update Date : 04/18/2024

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Directions to “ ANDREW LEWIS CECIL ” Practice Location

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