Provider Demographics
NPI:1316996382
Name:NEISH, ANDREW SCOTT (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:SCOTT
Last Name:NEISH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:615 MICHAEL ST NE
Mailing Address - Street 2:WHITEHEAD BIOMEDICAL RESEARCH BLDG., RM 105-F
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1047
Mailing Address - Country:US
Mailing Address - Phone:404-727-8545
Mailing Address - Fax:404-727-8538
Practice Address - Street 1:615 MICHAEL ST NE
Practice Address - Street 2:WHITEHEAD BIOMEDICAL RESEARCH BLDG., RM 105-F
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1047
Practice Address - Country:US
Practice Address - Phone:404-727-8545
Practice Address - Fax:404-727-8538
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-03-06
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Provider Licenses
StateLicense IDTaxonomies
GA044038207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA22BDCSBMedicare PIN
GAG57917Medicare UPIN