Provider Demographics
NPI:1528329083
Name:HUSS, ANDREW CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHARLES
Last Name:HUSS
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 1:1425 NW BLUE PKWY
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5705
Mailing Address - Country:US
Mailing Address - Phone:816-524-5600
Mailing Address - Fax:
Practice Address - Street 1:1600 NW SOUTH OUTER RD
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-2963
Practice Address - Country:US
Practice Address - Phone:816-525-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015013281208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2012016265OtherMISSOURI MEDICAL LICENSE