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NPI Code Detail

MEDICARE: ANDREW FITZGERALD PA-C

MEDICARE: ANDREW FITZGERALD PA-C
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
1363AM0700XMedical Physician Assistant50.004724RXOH

General Provider Information

NPI Number : 1861844573
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW FITZGERALD PA-C
Provider Business Mailing Address
First Line : 5695 PIN OAK LN
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-8758
Country : US
Telephone Number : 740-704-7916
Fax Number :
Provider Business Practice Location Address
First Line : 2049 E 100TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2104
Country : US
Telephone Number : 216-444-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2016
Last Update Date : 07/06/2016

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