Provider Demographics
NPI:1154423275
Name:MAY, ANDREW STEPHEN (MD, FAAFP)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEPHEN
Last Name:MAY
Suffix:
Gender:M
Credentials:MD, FAAFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2366
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37644-2366
Mailing Address - Country:US
Mailing Address - Phone:423-895-1765
Mailing Address - Fax:
Practice Address - Street 1:1200 SPRUCE LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-4301
Practice Address - Country:US
Practice Address - Phone:423-543-3202
Practice Address - Fax:423-543-6249
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD16050207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN30198761Medicaid
TN30198761Medicare PIN
TN30198761Medicaid