Provider Demographics
NPI:1063411601
Name:MAGNET, ANDREW DEAN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DEAN
Last Name:MAGNET
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 DAN PROCTOR DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-3810
Mailing Address - Country:US
Mailing Address - Phone:912-576-6200
Mailing Address - Fax:
Practice Address - Street 1:505 CROSSWIND DR
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-2777
Practice Address - Country:US
Practice Address - Phone:912-677-7739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-16
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060215207R00000X, 208M00000X
FLME117368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00609438OtherRR MEDICARE
SCG60215Medicaid
GA220002667AMedicaid
SCG60215Medicaid