Provider Demographics
NPI:1366478505
Name:MELTZER, ANDREW CHARLES (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHARLES
Last Name:MELTZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 THIRD STREET SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-0001
Mailing Address - Country:US
Mailing Address - Phone:202-445-7044
Mailing Address - Fax:202-741-2921
Practice Address - Street 1:2150 PENNSYLVANIA AVENUE NW
Practice Address - Street 2:SUITE 2B
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3307
Practice Address - Country:US
Practice Address - Phone:202-741-2904
Practice Address - Fax:202-741-2921
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062842207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD381221900Medicaid
MD381221900Medicaid
MDH254Medicare ID - Type UnspecifiedMEDICARE GRP #