MEDICARE: DR. MARY LOUISE ST. ANDRE MD

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	174400000X	Specialist	MD026926E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740255769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY LOUISE ST. ANDRE MD

Provider Business Mailing Address
First Line	:	4773 ROUTE 8
Second Line	:
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-2401
Country	:	US
Telephone Number	:	412-487-4438
Fax Number	:

Provider Business Practice Location Address
First Line	:	4773 ROUTE 8
Second Line	:
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-2401
Country	:	US
Telephone Number	:	412-487-4438
Fax Number	:

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/11/2011

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