Provider Demographics
NPI:1215930243
Name:VINCENT, ANDREW LLOYD (DPM)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LLOYD
Last Name:VINCENT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 CEDAR CREEK GRADE STE 108
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6453
Mailing Address - Country:US
Mailing Address - Phone:540-667-3338
Mailing Address - Fax:540-667-1589
Practice Address - Street 1:650 CEDAR CREEK GRADE STE 108
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6453
Practice Address - Country:US
Practice Address - Phone:540-667-3338
Practice Address - Fax:540-667-1589
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300898213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADD1110OtherRAILROAD MEDICARE GROUP
VA010135541Medicaid
VAP00209069OtherRAILROAD MEDICARE
VA173121OtherANTHEM
VA00W316F01Medicare UPIN
VAC09449Medicare PIN
VA5446600001Medicare NSC