Provider Demographics
NPI:1487755773
Name:ANDRAS, ROBERT LOUIS (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LOUIS
Last Name:ANDRAS
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 1:9611 PLAIN CITY GEORGESVILLE RD NE
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-8054
Mailing Address - Country:US
Mailing Address - Phone:614-873-5595
Mailing Address - Fax:
Practice Address - Street 1:9611 PLAIN CITY GEORGESVILLE RD NE
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-8054
Practice Address - Country:US
Practice Address - Phone:614-873-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH37448207P00000X
IN01062413A207P00000X
WV21947207P00000X
OH35.037448207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0278551Medicaid
A14847Medicare UPIN
OH4257677Medicare PIN
OH0278551Medicaid
OHAN4257676Medicare PIN
080958Medicare ID - Type Unspecified
OHAN4257679Medicare PIN