Provider Demographics
NPI:1063530921
Name:MCLANAHAN, ANDREW GREGG JR (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GREGG
Last Name:MCLANAHAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3101 W RIDGE RD
Mailing Address - Street 2:BUILDING C
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-3249
Mailing Address - Country:US
Mailing Address - Phone:585-225-1700
Mailing Address - Fax:
Practice Address - Street 1:3101 W RIDGE RD
Practice Address - Street 2:BUILDING C
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3249
Practice Address - Country:US
Practice Address - Phone:585-225-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY8736A207R00000X, 208000000X
NY257044208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics