MEDICARE: ANDREW STEPHEN PEARSON 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	207P00000X	Emergency Medicine Physician	MD2015-0571	NM

General Provider Information

NPI Number	:	1841253291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW STEPHEN PEARSON MD

Provider Business Mailing Address
First Line	:	4379 CONDOR ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-9640
Country	:	US
Telephone Number	:	575-642-1739
Fax Number	:

Provider Business Practice Location Address
First Line	:	4379 CONDOR ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-9640
Country	:	US
Telephone Number	:	575-642-1739
Fax Number	:

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	07/22/2015

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