Provider Demographics
NPI:1528048477
Name:ANDARY, LOUIS JR (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:ANDARY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1640 FORT ST
Mailing Address - Street 2:SUITE D ATTN DENISE
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2040
Mailing Address - Country:US
Mailing Address - Phone:734-391-3057
Mailing Address - Fax:734-391-3052
Practice Address - Street 1:23050 WEST RD
Practice Address - Street 2:STE 210
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1472
Practice Address - Country:US
Practice Address - Phone:734-282-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2021-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301043773207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H24657OtherBLUE CROSS
1457586646OtherGROUP NPI HENRY FORD WYANDOTTE
MIQ24657063Medicare PIN
1457586646OtherGROUP NPI HENRY FORD WYANDOTTE